Provider Demographics
NPI:1821292962
Name:BEZDEK, SEAN WILLIAM (MFT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:WILLIAM
Last Name:BEZDEK
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 1:9984 NIBLICK DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-7017
Mailing Address - Country:US
Mailing Address - Phone:916-945-3601
Mailing Address - Fax:
Practice Address - Street 1:9984 NIBLICK DR
Practice Address - Street 2:SUITE 2
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-7017
Practice Address - Country:US
Practice Address - Phone:916-945-3601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist