Provider Demographics
NPI:1578189411
Name:O'SHEA, SEAN (CAMTC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:CAMTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 FLAMING ARROW DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-4751
Mailing Address - Country:US
Mailing Address - Phone:916-532-1626
Mailing Address - Fax:
Practice Address - Street 1:6601 FLAMING ARROW DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4751
Practice Address - Country:US
Practice Address - Phone:916-532-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50732225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist