Provider Demographics
NPI:1053466755
Name:EGAN, SEAN KENNETH
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:KENNETH
Last Name:EGAN
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 1:2001 THE ALAMEDA
Mailing Address - Street 2:ALLIANCE FOR COMMUNITY CARE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1136
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-254-9960
Practice Address - Street 1:150A SOUTH AUTUMN STREET
Practice Address - Street 2:EMPLOYMENT SERVICES
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-2515
Practice Address - Country:US
Practice Address - Phone:408-938-8500
Practice Address - Fax:408-286-8988
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health