Provider Demographics
NPI:1710371158
Name:SEIGEN, LEA (MFT)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:SEIGEN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 FULTON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4318
Mailing Address - Country:US
Mailing Address - Phone:415-255-2509
Mailing Address - Fax:
Practice Address - Street 1:459 FULTON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4318
Practice Address - Country:US
Practice Address - Phone:415-255-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist