Provider Demographics
NPI:1245778620
Name:THEUS, SEAN (FNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:THEUS
Suffix:
Gender:M
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20955 DEVONSHIRE ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2313
Mailing Address - Country:US
Mailing Address - Phone:661-899-6767
Mailing Address - Fax:
Practice Address - Street 1:11150 WEST OLYMPIC BLVD
Practice Address - Street 2:760
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:424-307-9504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008284207Q00000X, 363LF0000X, 363LP0808X
AZAP9885363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health