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General NPI Number Information
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NPI Number | 1891144952
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Entity Type | Individual
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Provider Name | SEAN MICHAEL HUSTED PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3525 LOMA VISTA RD STE A
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City | VENTURA
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State | CA
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Zip | 93003-3165
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Country | US
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Telephone | 805-641-6415
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Fax | 805-641-6424
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Provider Business Mailing Address
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Address Line | 1203 FLYNN RD UNIT 160
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City | CAMARILLO
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State | CA
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Zip | 93012-6203
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Country | US
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Telephone | 805-804-4168
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Fax | 805-830-1177
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 293721
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P16340
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 58502
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License Number State | CA
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