MEDICARE: FLIN SADE OSHUN

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
1	1041C0700X	Clinical Social Worker	101074	CA

General Provider Information

NPI Number	:	1881355584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLIN SADE OSHUN

Provider Business Mailing Address
First Line	:	6780 GLORIA DR APT 9
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-2030
Country	:	US
Telephone Number	:	310-868-4909
Fax Number	:

Provider Business Practice Location Address
First Line	:	4125 TEMESCAL ST
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-7558
Country	:	US
Telephone Number	:	916-439-8211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	01/05/2022

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