Provider Demographics
NPI:1669779617
Name:SELDEEN, DONALD JOSEPH (PHD)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOSEPH
Last Name:SELDEEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HAPPY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-9789
Mailing Address - Country:US
Mailing Address - Phone:831-423-4605
Mailing Address - Fax:831-423-4605
Practice Address - Street 1:701 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-9789
Practice Address - Country:US
Practice Address - Phone:831-423-4605
Practice Address - Fax:831-423-4605
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10720103T00000X, 103TC0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy