Provider Demographics
NPI:1386456630
Name:SIENNA SHEA, INC.
Entity type:Organization
Organization Name:SIENNA SHEA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, HEAD OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-600-4113
Mailing Address - Street 1:30408 PASSAGEWAY PL
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2031
Mailing Address - Country:US
Mailing Address - Phone:310-600-4113
Mailing Address - Fax:
Practice Address - Street 1:30408 PASSAGEWAY PL
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2031
Practice Address - Country:US
Practice Address - Phone:310-600-4113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care