Individual provider Active NPI

Leon F. Seltzer, PH.D.

  • Clinical Psychologist
  • Del Mar, CA
National Provider Identifier
1093868010
Registry record updated Jul 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9596 Issued in CA
Practice address
14195 Mango Dr
Del Mar, CA 92014-2924
Phone
(858) 259-1190
NPI assigned
Jan 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9596 CA Primary
Psychologist 103T00000X PSY9596 CA

Addresses

Primary practice location

14195 Mango Dr
Del Mar, CA 92014-2924

Mailing address

14195 Mango Dr
Del Mar, CA 92014-2924
Phone (858) 259-1190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9596CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1093868010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14195 MANGO DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920142924",
            "telephone_number": "858-259-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14195 MANGO DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920142924",
            "telephone_number": "858-259-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "LEON",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9596",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.