Individual
SEAN WHITTEAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4411 E KINGS CANYON RD, FRESNO, CA 93702
(559) 600-7180
Mailing address
4411 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 600-7180
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95162669
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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