Sean Ahern, PT

Individual provider Active NPI Physical Therapist · Simi Valley, CA

NPI 1366058828 · NPPES record last updated Sep 21, 2020

Key facts

NPI
1366058828
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT19521 (CA)
Practice address
762 Twin Peaks Ave
Simi Valley, CA 93065-7059
Phone
(805) 428-3649
NPI assigned
Sep 21, 2020
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

LicenseStateTypeSpecialty
PT19521CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X PT19521 CA Yes

Addresses

Primary practice location

762 Twin Peaks Ave
Simi Valley, CA 93065-7059

Mailing address

762 Twin Peaks Ave
Simi Valley, CA 93065-7059
Phone (805) 428-3649

Other providers in Simi Valley, CA

All providers in Simi Valley, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.