Individual provider Active NPI

Sean Lynn

  • Marriage & Family Therapist
  • Redondo Beach, CA
National Provider Identifier
1124772314
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
115568 Issued in CA
Practice address
1200 Aviation Blvd Ste 102
Redondo Beach, CA 90278-4063
Phone
(714) 235-8858
NPI assigned
Feb 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 115568 CA Primary

Addresses

Primary practice location

1200 Aviation Blvd Ste 102
Redondo Beach, CA 90278-4063

Mailing address

1200 Aviation Blvd Ste 102
Redondo Beach, CA 90278-4063
Phone (714) 235-8858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
115568CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Lynn, Individual and Family Therapy, Inc. Current Accepting new patients

Locations

1200 Aviation Blvd
Ste 102
Redondo Beach, CA 90278
Phone (310) 612-6299

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1124772314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AVIATION BLVD STE 102",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784063",
            "telephone_number": "714-235-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 AVIATION BLVD STE 102",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784063",
            "telephone_number": "714-235-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.