Provider Demographics
NPI:1194128009
Name:GUINAN, SEAN PATRICK (LAC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:GUINAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 HARPER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3043
Mailing Address - Country:US
Mailing Address - Phone:831-332-5820
Mailing Address - Fax:
Practice Address - Street 1:8202 NE STATE HIGHWAY 104 STE 105
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9454
Practice Address - Country:US
Practice Address - Phone:360-297-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15984171100000X
WAAC 60583416171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist