Provider Demographics
NPI:1609357987
Name:SEIGHMAN, ELIZABETH BRIANNA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRIANNA
Last Name:SEIGHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92033-0099
Mailing Address - Country:US
Mailing Address - Phone:760-543-6541
Mailing Address - Fax:
Practice Address - Street 1:334 VIA VERA CRUZ STE 107
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2637
Practice Address - Country:US
Practice Address - Phone:760-304-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180822001090103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst