Healthcare Provider Details

I. General information

NPI: 1841607017
Provider Name (Legal Business Name): SEAN CUYPERS LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4344 LATHAM ST STE 110
RIVERSIDE CA
92501-1773
US

IV. Provider business mailing address

4344 LATHAM ST STE 110
RIVERSIDE CA
92501-1773
US

V. Phone/Fax

Practice location:
  • Phone: 951-742-0462
  • Fax: 999-999-9999
Mailing address:
  • Phone: 951-742-0462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110865
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: