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NPI Code Detail

MEDICARE: IRELAND SHEA CULLINAN

MEDICARE: IRELAND SHEA CULLINAN
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
1225400000XRehabilitation PractitionerCA
2171M00000XCase Manager/Care Coordinator
3171400000XHealth & Wellness CoachCA
4172V00000XCommunity Health WorkerCA
5106S00000XBehavior Technician

General Provider Information

NPI Number : 1023668449
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRELAND SHEA CULLINAN
Provider Business Mailing Address
First Line : 499 LOMA ALTA AVE
Second Line :
City : LOS GATOS
State : CA
Zip : 95030-6227
Country : US
Telephone Number : 408-364-4157
Fax Number :
Provider Business Practice Location Address
First Line : 499 LOMA ALTA AVE
Second Line :
City : LOS GATOS
State : CA
Zip : 95030-6227
Country : US
Telephone Number : 760-636-9116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 02/09/2026

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Directions to “ IRELAND SHEA CULLINAN ” Practice Location

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