Provider Demographics
NPI:1699861419
Name:SEYMOUR, JENNIFER T (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:T
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 ARABELLA CT
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-2477
Mailing Address - Country:US
Mailing Address - Phone:415-250-5141
Mailing Address - Fax:
Practice Address - Street 1:24900 HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-5558
Practice Address - Country:US
Practice Address - Phone:661-822-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21578103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical