Individual provider Active NPI

Donald Luke Miller Seltzer III III, PSY.D.

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1790122570
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31511 Issued in CA
Practice address
1619 E Chapman Ave
Fullerton, CA 92831-4015
Phone
(714) 485-7949
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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 31511 CA Primary
Clinical Psychologist 103TC0700X PSB94023140 CA

Addresses

Primary practice location

1619 E Chapman Ave
Fullerton, CA 92831-4015

Mailing address

1619 E Chapman Ave
Fullerton, CA 92831-4015
Phone (714) 485-7949

Other names 1

  • Dr. Luke Seltzer Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303000591 CA Practitioner - Clinical Psychologist 6507293610 Reassigns benefits to 1 organization
Practice locations: Fullerton, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1619 E Chapman Ave
Fullerton, CA 92831-4015
Phone (714) 485-7949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSB94023140CAMDClinical Psychologist
31511CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Psychological Corporation Clinical CurrentSince May 1, 2025 Accepting new patients

Locations

1619 E Chapman Ave
Fullerton, CA 92831
Phone (714) 420-1515

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1790122570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314015",
            "telephone_number": "714-485-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314015",
            "telephone_number": "714-485-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER III",
        "first_name": "DONALD LUKE",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31511",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94023140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUKE",
            "last_name": "SELTZER",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.