Provider Demographics
NPI:1013616812
Name:AL-SEILAWI, GHADA (EDUCATIONAL PSYCHOLO)
Entity type:Individual
Prefix:
First Name:GHADA
Middle Name:
Last Name:AL-SEILAWI
Suffix:
Gender:F
Credentials:EDUCATIONAL PSYCHOLO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W YALE LOOP
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3621
Mailing Address - Country:US
Mailing Address - Phone:949-878-0909
Mailing Address - Fax:
Practice Address - Street 1:1001 DOVE ST STE 270
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2851
Practice Address - Country:US
Practice Address - Phone:949-432-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist