Provider Demographics
NPI:1811662851
Name:SEALE, LINDA ALLEGRA (MA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ALLEGRA
Last Name:SEALE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALLEGRA
Other - Middle Name:
Other - Last Name:SEALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1510 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1220
Mailing Address - Country:US
Mailing Address - Phone:650-493-8740
Mailing Address - Fax:
Practice Address - Street 1:1510 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1220
Practice Address - Country:US
Practice Address - Phone:650-493-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10245106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist