Provider Demographics
NPI:1770504946
Name:SEITZ, THOMAS BRUCE (LMFT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:BRUCE
Last Name:SEITZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 W KATELLA AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-3451
Mailing Address - Country:US
Mailing Address - Phone:714-399-3480
Mailing Address - Fax:714-399-3481
Practice Address - Street 1:1855 W KATELLA AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-3451
Practice Address - Country:US
Practice Address - Phone:714-399-3480
Practice Address - Fax:714-399-3481
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23781106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist