Healthcare Provider Details

I. General information

NPI: 1972806586
Provider Name (Legal Business Name): SEAN CARTER M.A HRM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W VERMONT AVE STE 101
ESCONDIDO CA
92025-6584
US

IV. Provider business mailing address

474 W VERMONT AVE STE 101
ESCONDIDO CA
92025-6584
US

V. Phone/Fax

Practice location:
  • Phone: 760-227-1530
  • Fax: 760-888-8339
Mailing address:
  • Phone: 760-227-1530
  • Fax: 619-615-0705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-QIKCWU
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: