Provider Demographics
NPI:1417615774
Name:WILLIAMS-SEYMORE, TREY'VONNE MARSEILLE (RN)
Entity Type:Individual
Prefix:MR
First Name:TREY'VONNE
Middle Name:MARSEILLE
Last Name:WILLIAMS-SEYMORE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SHAVANO WAY
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4187
Mailing Address - Country:US
Mailing Address - Phone:425-240-2943
Mailing Address - Fax:
Practice Address - Street 1:2050 FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1001
Practice Address - Country:US
Practice Address - Phone:425-240-2943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9551729163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163W00000XNursing Service ProvidersRegistered Nurse