Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | CA |
NPI | 1003287889 |
---|---|
Provider Name | Gregory Sheehan |
First Address | Burlingame, CA 94010-2738 |
Second Address | San Mateo, CA 94401-1653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2015 |
Last Update Date | 19/10/2015 |