Provider Demographics
NPI:1598426124
Name:FOREMAN, SEAN PATRICK
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:FOREMAN
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 1:539 SOLARIS LN
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:95524-9068
Mailing Address - Country:US
Mailing Address - Phone:707-498-8641
Mailing Address - Fax:
Practice Address - Street 1:2413 2ND ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0811
Practice Address - Country:US
Practice Address - Phone:707-269-9590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)