Provider Demographics
NPI:1245478692
Name:SEFFINGER, DEBORAH (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:SEFFINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10722 ARROW ROUTE
Mailing Address - Street 2:SUITE 314
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4811
Mailing Address - Country:US
Mailing Address - Phone:909-484-8888
Mailing Address - Fax:909-581-0920
Practice Address - Street 1:10722 ARROW ROUTE
Practice Address - Street 2:SUITE 314
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4811
Practice Address - Country:US
Practice Address - Phone:909-484-8888
Practice Address - Fax:909-581-0920
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22246103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABP323AMedicare UPIN