MEDICARE: SEAN SOUZA

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	3747A0650X	Attendant Care Provider	304700389	CA

General Provider Information

NPI Number	:	1801627682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN SOUZA

Provider Business Mailing Address
First Line	:	7111 GARDEN GROVE BLVD STE 100
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-4222
Country	:	US
Telephone Number	:	562-848-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	7111 GARDEN GROVE BLVD STE 100
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-4222
Country	:	US
Telephone Number	:	562-848-2273
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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Directions to “ SEAN SOUZA ” Practice Location

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