MEDICARE: SHAELYN SICK

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	225100000X	Physical Therapist	PT300424	CA
2	225100000X	Physical Therapist	13310	SC

General Provider Information

NPI Number	:	1023681061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAELYN SICK

Provider Business Mailing Address
First Line	:	142 RILEY FARMS CT
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-8419
Country	:	US
Telephone Number	:	530-966-5396
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 SOSCOL AVE STE B191
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-4040
Country	:	US
Telephone Number	:	707-900-2368
Fax Number	:

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

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	04/27/2026

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Directions to “ SHAELYN SICK ” Practice Location

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