Provider Demographics
NPI:1528155587
Name:RILEY, SEAN PATRICK (PSYD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:RILEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207A SANCHEZ ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1613
Mailing Address - Country:US
Mailing Address - Phone:415-948-4454
Mailing Address - Fax:415-626-1072
Practice Address - Street 1:207A SANCHEZ ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1613
Practice Address - Country:US
Practice Address - Phone:415-948-4454
Practice Address - Fax:415-626-1072
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical