DR. SEAN DOUGHERTY, DPM, INC. (NPI# 1518573310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518573310 |
| Entity Type | Organization |
| Organization Name | DR. SEAN DOUGHERTY, DPM, INC. |
| Practice Address |
1620 Pennsylvania Ave Ste A Fairfield CA 94533-3509 |
| Practice Telephone | 7074265644 |
| Practice Fax Number | 7074263156 |
| Mailing Telephone | 7074265644 |
| Mailing Fax Number | 7074263156 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | DR. SEAN M DOUGHERTY (OWNER) |
| Authorized Official Telephone | 7074265644 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities |
| Street Address |
1620 PENNSYLVANIA AVE STE A |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407089261 | Sean Michael Dougherty | Podiatrist | 1620 Pennsylvania Ave Ste A, Fairfield, CA 94533-3509 | 2009-08-27 |
| 1992123384 | Camilla Willson | Podiatrist | 1620 Pennsylvania Ave Ste A, Fairfield, CA 94533-3509 | 2014-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811519515 | Collins Podiatry Corporation | Clinic/Center | 1223 Grant Ave Ste D, Novato, CA 94945-3157 | 2020-05-15 |
| 1427683523 | Inderjeet Bhamra Dpm PC | Clinic/Center | 2685 Hesselbein Way, San Jose, CA 95148-2515 | 2020-03-09 |
| 1073159794 | Jafary Foot & Ankle Specialists Inc | Clinic/Center | 4706 Sepulveda Blvd Apt 202, Sherman Oaks, CA 91403-2478 | 2019-11-19 |
| 1154882678 | Philip S Schauweker D.p.m. Professional Podiatric Medicine Corporation | Clinic/Center | 1043 Elm Ave Ste 407, Long Beach, CA 90813-3206 | 2019-03-27 |
| 1619456704 | Dr. Vijay Mandyam | Clinic/Center | 43713 20th St W Ste 3, Lancaster, CA 93534-4628 | 2018-08-09 |
| 1730676958 | Claire E. Futenma, Dpm, Inc. | Clinic/Center | 131 N El Molino Ave Ste 230, Pasadena, CA 91101-1877 | 2018-04-13 |
| 1598265431 | Zargar Podiatry Inc | Clinic/Center | 370 Elan Village Ln Unit 321, San Jose, CA 95134-2535 | 2018-02-16 |
| 1255847638 | Szm Medical Corp | Clinic/Center | 1687 Erringer Rd Ste 206, Simi Valley, CA 93065-6509 | 2017-12-20 |
| 1134630981 | Huntington Foot & Ankle Care, Inc. | Clinic/Center | 18682 Beach Blvd Ste 140, Huntington Beach, CA 92648-2050 | 2017-10-19 |
| 1023485422 | Steven F Kaplan Dpm A Professional Podiatric Corporation Inc. | Clinic/Center | 404 W Baseline Rd, Glendora, CA 91740-4801 | 2015-09-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.