Provider Demographics
NPI:1831880186
Name:MCCARTHY, SHEALEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:SHEALEY
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 ACACIA ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8024
Mailing Address - Country:US
Mailing Address - Phone:805-603-0885
Mailing Address - Fax:
Practice Address - Street 1:7777 W 38TH AVE UNIT A124
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6170
Practice Address - Country:US
Practice Address - Phone:303-940-0757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304055225100000X
COPTL.0020007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist