Provider Demographics
NPI:1841325966
Name:DEES, SEAN M (PT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:DEES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2710
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-2710
Mailing Address - Country:US
Mailing Address - Phone:916-932-1205
Mailing Address - Fax:
Practice Address - Street 1:1650 LEAD HILL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3072
Practice Address - Country:US
Practice Address - Phone:916-932-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02588ZMedicare UPIN
CAAW237XMedicare PIN
CAZZZ30106ZMedicare PIN
CAAW237YMedicare PIN
CAZZZ23993ZMedicare PIN