Provider Demographics
NPI:1730268707
Name:SEGEBERG, DONNA JAYNE (RN)
Entity type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:JAYNE
Last Name:SEGEBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19181 COENSON CIR
Mailing Address - Street 2:APT B
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2341
Mailing Address - Country:US
Mailing Address - Phone:714-469-4881
Mailing Address - Fax:
Practice Address - Street 1:3100 S HARBOR BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6823
Practice Address - Country:US
Practice Address - Phone:714-966-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA547157163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent