Provider Demographics
NPI:1922150408
Name:SEGURA, RAYMOND (NONE)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:SEGURA
Suffix:
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 S MCCLELLAND ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6618
Mailing Address - Country:US
Mailing Address - Phone:805-614-1373
Mailing Address - Fax:805-614-1571
Practice Address - Street 1:912 S MCCLELLAND ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6618
Practice Address - Country:US
Practice Address - Phone:805-614-1373
Practice Address - Fax:805-614-1571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker