Provider Demographics
NPI:1043914690
Name:WOOLERY, SEAN (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WOOLERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8445 HIHN RD
Mailing Address - Street 2:
Mailing Address - City:BEN LOMOND
Mailing Address - State:CA
Mailing Address - Zip Code:95005-9606
Mailing Address - Country:US
Mailing Address - Phone:831-818-3824
Mailing Address - Fax:
Practice Address - Street 1:1715 42ND AVE STE B
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3557
Practice Address - Country:US
Practice Address - Phone:831-515-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor