Provider Demographics
NPI:1053874057
Name:SEEWALD, STEPHANIE DYAN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:DYAN
Last Name:SEEWALD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:SEEWALD
Other - Last Name:GUARDIOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:737 DALLAS STREET
Mailing Address - Street 2:UNIT B
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064
Mailing Address - Country:US
Mailing Address - Phone:830-570-7634
Mailing Address - Fax:
Practice Address - Street 1:109 N. SMITH
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064
Practice Address - Country:US
Practice Address - Phone:830-281-8367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141281363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics