Provider Demographics
NPI:1831754704
Name:SEYDEL, FEDERICA
Entity type:Individual
Prefix:MS
First Name:FEDERICA
Middle Name:
Last Name:SEYDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 S WINCHESTER BLVD APT 58
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4323
Mailing Address - Country:US
Mailing Address - Phone:707-492-0150
Mailing Address - Fax:
Practice Address - Street 1:5330 COLLEGE AVE STE 240
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-2814
Practice Address - Country:US
Practice Address - Phone:888-362-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician