Audrey Elaine Seaton-Bacon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY16171 Issued in CA

Practice address

1338 Center Court Dr Ste 102
Covina, CA 91724-3681

Phone

(562) 907-9196

Fax

(562) 479-0365

NPI assigned

Apr 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Chesed Counseling and Coaching Center, LLC

  • Clinical Psychologist
  • Potosi, MO
  • NPI 1295451805
  NPD Authorized official

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1922065564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636010585",
            "telephone_number": "562-907-9196",
            "fax_number": "562-479-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 CENTER COURT DR STE 102",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243681",
            "telephone_number": "562-907-9196",
            "fax_number": "562-479-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEATON-BACON",
        "first_name": "AUDREY",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2023-05-23",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venessa Hilaire Scott Kane, LPN
• Kathryn Carter Scott
• Kyle Scott
• Sharon Scott, MF
• Yanira Madia Scott
• Estefany Segovia
• McKayla Segovia
• Christine Seng
• Sipra Sengupta, LMFT
• Kelley Serena, M.A., BCBA

• Clinical Psychologist in Covina, CA
• Providers in Covina, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.