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NPI Code Detail

MEDICARE: SEAN CICCARELLI B.A.

MEDICARE: SEAN CICCARELLI B.A.
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 Counselor

General Provider Information

NPI Number : 1801074562
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN CICCARELLI B.A.
Provider Business Mailing Address
First Line : 201 N K ST
Second Line :
City : TULARE
State : CA
Zip : 93274-4005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 N K ST
Second Line :
City : TULARE
State : CA
Zip : 93274-4005
Country : US
Telephone Number : 559-687-0929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2008
Last Update Date : 02/05/2008

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Directions to “ SEAN CICCARELLI B.A.” Practice Location

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