Provider Demographics
NPI:1326704453
Name:SEYYEDI, MOJDEH NEWSHA (RN)
Entity Type:Individual
Prefix:
First Name:MOJDEH
Middle Name:NEWSHA
Last Name:SEYYEDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13428 POWAY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-7004
Mailing Address - Country:US
Mailing Address - Phone:858-602-7237
Mailing Address - Fax:
Practice Address - Street 1:13428 POWAY CREEK RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-7004
Practice Address - Country:US
Practice Address - Phone:858-602-7237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813861163WC0200X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine