=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275179210
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SEAN YAW-SHYANG TSAI
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2019
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17701 SAN PASQUAL VALLEY RD # 2023
-----------------------------------------------------
City | ESCONDIDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92025-5301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-617-4886
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6943 AMBER LN
-----------------------------------------------------
City | CARLSBAD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92009-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-812-9988
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 127618
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------