Provider Demographics
NPI:1972760254
Name:SHEEHY, MATT J (DC)
Entity type:Individual
Prefix:DR
First Name:MATT
Middle Name:J
Last Name:SHEEHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:21580 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1244
Mailing Address - Country:US
Mailing Address - Phone:408-569-2374
Mailing Address - Fax:408-252-4960
Practice Address - Street 1:21580 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1244
Practice Address - Country:US
Practice Address - Phone:408-569-2374
Practice Address - Fax:408-252-4960
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor