Active NPI
Sean Norris, PA-C
- Physician Assistant
- Antioch, CA
National Provider Identifier
1700016938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA20427
- Practice address
- 3901 Lone Tree Way
Antioch, CA 94509-6200 - Phone
- (925) 779-7200
- Fax
- (925) 779-3006
- NPI assigned
- Jul 22, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA20427 | CA | Primary |
Addresses
Primary practice location
3901 Lone Tree Way
Antioch, CA 94509-6200
Mailing address
3901 Lone Tree Way
Antioch, CA 94509-6200
Phone (925) 779-7200
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA20427 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1700016938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 LONE TREE WAY",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945096200",
"telephone_number": "925-779-7200",
"fax_number": "925-779-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 LONE TREE WAY",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945096200",
"telephone_number": "925-779-7200",
"fax_number": "925-779-3006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORRIS",
"first_name": "SEAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-22",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA20427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.