Provider Demographics
NPI:1295119998
Name:SEKI, HIDENORI
Entity type:Individual
Prefix:
First Name:HIDENORI
Middle Name:
Last Name:SEKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3820
Mailing Address - Country:US
Mailing Address - Phone:016-485-2172
Mailing Address - Fax:916-484-0263
Practice Address - Street 1:3817 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-3820
Practice Address - Country:US
Practice Address - Phone:016-485-2172
Practice Address - Fax:916-484-0263
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347005168171M00000X
CA347005109171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator