Provider Demographics
NPI:1487145819
Name:SEDA TERZYAN, A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:SEDA TERZYAN, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-783-9590
Mailing Address - Street 1:250 NEWPORT CENTER DR STE M106
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7516
Mailing Address - Country:US
Mailing Address - Phone:949-783-9590
Mailing Address - Fax:855-681-6902
Practice Address - Street 1:250 NEWPORT CENTER DR STE M106
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7516
Practice Address - Country:US
Practice Address - Phone:949-783-9590
Practice Address - Fax:855-681-6902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29251103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty