MEDICARE: SEAN K WILLIAMS OT

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	225X00000X	Occupational Therapist	22482	CA

General Provider Information

NPI Number	:	1891465829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN K WILLIAMS OT

Provider Business Mailing Address
First Line	:	640 RICHLAND VIEW CT
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-9660
Country	:	US
Telephone Number	:	408-620-4782
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 N LA BREA AVE FL 4
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90038-3161
Country	:	US
Telephone Number	:	725-209-3053
Fax Number	:	855-927-7788

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

Provider Enumeration Date	:	09/21/2021
Last Update Date	:	09/26/2025

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