Provider Demographics
NPI:1407162712
Name:SEABAUGH, MICHAEL OL (PSYCHOLOGIST (CALIFO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:OL
Last Name:SEABAUGH
Suffix:
Gender:M
Credentials:PSYCHOLOGIST (CALIFO
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REGISTERED PSYCH ASS
Mailing Address - Street 1:11 W. VICTORIA
Mailing Address - Street 2:STE 209
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101
Mailing Address - Country:US
Mailing Address - Phone:805-568-5100
Mailing Address - Fax:
Practice Address - Street 1:11 W. VICTORIA
Practice Address - Street 2:STE 209
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101
Practice Address - Country:US
Practice Address - Phone:805-568-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist