Provider Demographics
NPI:1255640454
Name:SEIPPEL, CAMILLA S (PSYD)
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:S
Last Name:SEIPPEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16702 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5824
Mailing Address - Country:US
Mailing Address - Phone:888-795-0555
Mailing Address - Fax:562-404-0266
Practice Address - Street 1:1717 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-4345
Practice Address - Country:US
Practice Address - Phone:888-795-0555
Practice Address - Fax:714-635-8547
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32962103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical