Healthcare Provider Details
I. General information
NPI: 1902720220
Provider Name (Legal Business Name): SEAN NOE
Entity Type: Individual
Gender:
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
169 SAXONY RD STE 211
ENCINITAS CA
92024-6780
US
IV. Provider business mailing address
169 SAXONY RD STE 211
ENCINITAS CA
92024-6780
US
V. Phone/Fax
- Phone: 760-209-6842
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PSB94029039 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: