Provider Demographics
NPI:1770588956
Name:SEIBERLICH, EILEEN SANDRA (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:SANDRA
Last Name:SEIBERLICH
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HODENCAMP RD
Mailing Address - Street 2:STE 100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5836
Mailing Address - Country:US
Mailing Address - Phone:805-495-0516
Mailing Address - Fax:
Practice Address - Street 1:101 HODENCAMP RD
Practice Address - Street 2:STE 100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5836
Practice Address - Country:US
Practice Address - Phone:805-495-0516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT5585225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4484430001OtherDMERC
CA4484430001OtherDMERC