Provider Demographics
NPI:1265211197
Name:KLEVER, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:KLEVER
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 1:12450 W CINNABAR AVE
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-3260
Mailing Address - Country:US
Mailing Address - Phone:818-618-8079
Mailing Address - Fax:
Practice Address - Street 1:12450 W CINNABAR AVE
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-3260
Practice Address - Country:US
Practice Address - Phone:818-618-8079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator