Provider Demographics
NPI:1942398201
Name:SEIBER, JOANNE NIELSEN (DPT)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:NIELSEN
Last Name:SEIBER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WINDWARD LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3718
Mailing Address - Country:US
Mailing Address - Phone:949-650-1591
Mailing Address - Fax:
Practice Address - Street 1:1980 MAIN ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-7200
Practice Address - Country:US
Practice Address - Phone:949-258-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23415OtherPT LICENSE #