MEDICARE: SEAN HENRY KIRKWOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	33906	CA

General Provider Information

NPI Number	:	1013850163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN HENRY KIRKWOOD

Provider Business Mailing Address
First Line	:	20633 QUEDO DR
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-3420
Country	:	US
Telephone Number	:	949-870-0170
Fax Number	:

Provider Business Practice Location Address
First Line	:	20633 QUEDO DR
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-3420
Country	:	US
Telephone Number	:	949-870-0170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ SEAN HENRY KIRKWOOD ” Practice Location

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