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NPI Code Detail

MEDICARE: SYDNEY EGAN

MEDICARE:   SYDNEY  EGAN
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
1101YM0800XMental Health Counselor157665CA
2101YM0800XMental Health Counselor20217CA

General Provider Information

NPI Number : 1184357790
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY EGAN
Provider Business Mailing Address
First Line : 4510 E PACIFIC COAST HWY STE 4304510E
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-3279
Country : US
Telephone Number : 310-697-9926
Fax Number :
Provider Business Practice Location Address
First Line : 2750 S HARBOR BLVD STE G
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-5820
Country : US
Telephone Number : 310-697-9926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2022
Last Update Date : 06/02/2026

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Directions to “ SYDNEY EGAN ” Practice Location

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