Provider Demographics
NPI:1336481043
Name:HORMONE REJUVENATION CENTER-CA
Entity Type:Organization
Organization Name:HORMONE REJUVENATION CENTER-CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:949-528-3942
Mailing Address - Street 1:1901 WESTCLIFF DR STE 3
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5505
Mailing Address - Country:US
Mailing Address - Phone:949-528-3942
Mailing Address - Fax:206-984-0555
Practice Address - Street 1:1901 WESTCLIFF DR STE 3
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5505
Practice Address - Country:US
Practice Address - Phone:949-528-3942
Practice Address - Fax:206-984-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-475175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty