Provider Demographics
NPI:1710294988
Name:STEVENS, SEAN DAVID (MFT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:DAVID
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N A ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-4916
Mailing Address - Country:US
Mailing Address - Phone:805-487-2244
Mailing Address - Fax:805-487-2255
Practice Address - Street 1:410 N A ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-4916
Practice Address - Country:US
Practice Address - Phone:805-487-2244
Practice Address - Fax:805-487-2255
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist