Individual provider Active NPI

Sean P Stephan, DPT

  • Physical Therapist
  • Ventura, CA
National Provider Identifier
1750407771
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33354 Issued in CA
Practice address
2895 Loma Vista Rd Ste H
Ventura, CA 93003-1542
Phone
(805) 765-4773
Fax
(805) 681-1768
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 33354 CA Primary

Addresses

Primary practice location

2895 Loma Vista Rd Ste H
Ventura, CA 93003-1542

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1760

Other identifiers 1

IdentifierTypeStateIssuer
CU048ZOtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000671 CA Practitioner - Physical Therapist in Private Practice 4486798758 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33354CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kealia Kai Inc. Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Dec 14, 2023 Accepting new patients
Two Trees Physical Therapy & Wellness Inc Physical Therapist CurrentSince Jul 20, 2016 Accepting new patients
Two Trees Physical Therapy & Wellness Inc Physical Therapist CurrentSince Jul 20, 2016 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

2895 Loma Vista Rd
Ste H
Ventura, CA 93003
Phone (805) 269-6316

3418 Loma Vista Rd
Ste A
Ventura, CA 93003
Phone (805) 642-8565

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1750407771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1760",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 LOMA VISTA RD STE H",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031542",
            "telephone_number": "805-765-4773",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "SEAN",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CU048Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.