Provider Demographics
NPI:1467584763
Name:SEIERSEN, CHRISTOPHER PAUL (MFC, PSYD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:SEIERSEN
Suffix:
Gender:M
Credentials:MFC, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 DOVER DR
Mailing Address - Street 2:SUITE 31
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5933
Mailing Address - Country:US
Mailing Address - Phone:949-515-7287
Mailing Address - Fax:
Practice Address - Street 1:833 DOVER DR
Practice Address - Street 2:SUITE 31
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5933
Practice Address - Country:US
Practice Address - Phone:949-515-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30742106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist