Provider Demographics
NPI:1073320404
Name:CARR, SEAN PATRICK (NBC-HWC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:CARR
Suffix:
Gender:M
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 AZURE CT
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-9218
Mailing Address - Country:US
Mailing Address - Phone:925-775-9495
Mailing Address - Fax:
Practice Address - Street 1:2940 SUMMIT ST STE 2D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3416
Practice Address - Country:US
Practice Address - Phone:925-633-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach