Provider Demographics
NPI:1659571024
Name:SEELEY, CHERIDAH JONES (PAC)
Entity Type:Individual
Prefix:MRS
First Name:CHERIDAH
Middle Name:JONES
Last Name:SEELEY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38900 TRADE CENTER DR STE B
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3715
Mailing Address - Country:US
Mailing Address - Phone:661-839-0574
Mailing Address - Fax:661-839-0963
Practice Address - Street 1:44215 15TH ST W STE 315
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5505
Practice Address - Country:US
Practice Address - Phone:661-945-4581
Practice Address - Fax:661-949-5887
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13993363A00000X, 363AM0700X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical