Healthcare Provider Details

I. General information

NPI: 1366373219
Provider Name (Legal Business Name): SHAWN HRYMACK
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 MORRIS KYLE DR
FIREBAUGH CA
93622-9711
US

IV. Provider business mailing address

19 PARKSIDE CIR
LEVITTOWN PA
19056-3501
US

V. Phone/Fax

Practice location:
  • Phone: 559-659-1476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: