Provider Demographics
NPI:1962422576
Name:SEVIDAL, JOCELYN L (MD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:L
Last Name:SEVIDAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22855 CANTARA STREET
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304
Mailing Address - Country:US
Mailing Address - Phone:818-825-2210
Mailing Address - Fax:
Practice Address - Street 1:11600 INDIAN HILLS ROAD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-838-4530
Practice Address - Fax:818-838-7516
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74931208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics