Sean Gray
Individual provider Active NPI Physical Therapy Assistant · Foothill Ranch, CA
NPI 1346638525 · NPPES record last updated Dec 22, 2014
Key facts
- NPI
- 1346638525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 10162 (CA)
- Practice address
- 27442 Portola Pkwy
Suite 200
Foothill Ranch, CA 92610-2823 - Phone
- (949) 282-5900
- NPI assigned
- Dec 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10162 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 10162 | CA | Yes |
Addresses
Primary practice location
27442 Portola Pkwy
Suite 200
Foothill Ranch, CA 92610-2823
Mailing address
2729 Teresita St
San Diego, CA 92104-5254
Phone (619) 616-3735
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- Consuelo Kaye Grimes
- Gulraiz Medical and Psychiatric Nursing Care
- Maryam Gulraiz
- Soha Haghani
- Michale Wayne Hamlin
All providers in Foothill Ranch, CA · Physical Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.