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NPI Code Detail

MEDICARE: DR. SEAN FITZGERALD

MEDICARE: DR. SEAN FITZGERALD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2193CA
2101YP2500XProfessional CounselorLH60626779WA

General Provider Information

NPI Number : 1215302096
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN FITZGERALD
Provider Business Mailing Address
First Line : 271 WINSLOW WAY E
Second Line : #11122
City : BAINBRIDGE ISLAND
State : WA
Zip : 98110
Country : US
Telephone Number : 206-822-2400
Fax Number :
Provider Business Practice Location Address
First Line : 1902 ORANGE TREE LN STE 200
Second Line :
City : REDLANDS
State : CA
Zip : 92374-2800
Country : US
Telephone Number : 909-798-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2015
Last Update Date : 09/11/2024

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Directions to “ DR. SEAN FITZGERALD ” Practice Location

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