Provider Demographics
NPI:1356742993
Name:SEITMAN, MATTHEW AVRUM (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:AVRUM
Last Name:SEITMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5557 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-1803
Mailing Address - Country:US
Mailing Address - Phone:619-635-2634
Mailing Address - Fax:
Practice Address - Street 1:2635 CAMINO DEL RIO S STE 303
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3729
Practice Address - Country:US
Practice Address - Phone:619-635-2634
Practice Address - Fax:619-632-5001
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34512103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical