SEAN CANARY KENNEDY (NPI# 1528156858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528156858 |
| Entity Type | Individual |
| Full Name | SEAN CANARY KENNEDY |
| Credential | MD |
| Practice Address |
1 Shields Ave Cowell Health Center Davis CA 95616 |
| Mailing Address |
1637 Westshore St Davis CA 95616-2973 |
| Practice Telephone | 5307522300 |
| Practice Fax Number | 5307522306 |
| Mailing Telephone | 5307522300 |
| Mailing Fax Number | 5307522306 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
A043076 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982957619 | Sean P Kennedy | Technician | 943 Indian Way, Peach Springs, AZ 86434 | 2012-10-18 |
| 1396368171 | Sean Kennedy | Internal Medicine | 1415 Woodland Ave Ste 140, Des Moines, IA 50309-3203 | 2020-05-27 |
| 1538729314 | Sean Kennedy | Podiatrist | 4150 Clement St Bldg 200, San Francisco, CA 94121-1563 | 2019-06-14 |
| 1396221719 | Sean Joseph Kennedy | Counselor | 1149 Warren Ave, Vallejo, CA 94591-7512 | 2018-07-18 |
| 1033581913 | Sean Kennedy | Counselor | 1235 Mission St, San Francisco, CA 94103-2705 | 2015-10-30 |
| 1740666718 | Sean Kennedy | Pharmacist | 1 Flower Valley Shopping Ctr, Florissant, MO 63033-1644 | 2015-07-31 |
| 1942681150 | Sean Kennedy | Family Medicine | 2972 Indian Trail Rd Ste A, Aurora, IL 60502-9408 | 2015-06-12 |
| 1508124629 | Sean Kennedy | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202 | 2012-04-26 |
| 1417001025 | Sean Michael Kennedy | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2007-01-22 |
| 1164583092 | Sean M. Kennedy | Physician Assistant | 39400 Paseo Padre Pkwy, Surgery Dept - Embarcadero Bldg, Fremont, CA 94538-2310 | 2006-12-13 |
| Street Address |
1 SHIELDS AVE COWELL HEALTH CENTER |
| City | DAVIS |
| State | CA |
| Zip Code | 95616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356322903 | Aimee Sisson | Student in an Organized Health Care Education/Training Program | 1 Shields Ave, Uc Davis Master of Public Health Program, Davis, CA 95616-5270 | 2005-11-10 |
| 1811597941 | Anna Pavlov | Registered Nurse | 1 Shields Ave, Davis, CA 95616-5270 | 2020-10-28 |
| 1811548779 | Sarah Schmitt | Dietitian, Registered | 1 Shields Ave, Davis, CA 95616-5270 | 2019-09-23 |
| 1619526373 | Vida Khaliki | Physician Assistant | 1 Shields Ave, Davis, CA 95616-5200 | 2019-09-05 |
| 1912496563 | Lisa Kay Varnum | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616-5200 | 2018-05-08 |
| 1730682022 | Sean Carrington | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616 | 2018-03-13 |
| 1720502701 | Torie Johnson | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616-5270 | 2017-08-01 |
| 1073044350 | Uc Davis Student Health and Counseling Services | Clinic/Center | 1 Shields Ave, Shcs, Davis, CA 95616-5270 | 2017-03-27 |
| 1992247092 | Lauren Eichstadt | Pharmacist | 1 Shields Ave, Davis, CA 95616-5270 | 2016-11-07 |
| 1467906222 | Duane Robinson | Specialist | 1 Shields Ave, School of Vet Med, Uc Davis, Davis, CA 95616-5270 | 2016-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194040063 | Michael Wilkes | Internal Medicine | 1 Shields Ave, Davis, CA 95616-5270 | 2010-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396115853 | Cedars Primary Care Apmc | Internal Medicine | 18370 Burbank Blvd Ste 201, Tarzana, CA 91356-2853 | 2015-09-28 |
| 1669886933 | Marius Viseroi | Internal Medicine | 3231 Waring Ct Ste D, Oceanside, CA 92056-4510 | 2014-06-16 |
| 1730314378 | Lofty L Basta | Internal Medicine | 765 Market St Apt 35a, San Francisco, CA 94103-2041 | 2009-05-27 |
| 1659534766 | Goodfaith Family Medical Clinic | Internal Medicine | 7540 Garvey Ave Ste C, Rosemead, CA 91770-2960 | 2008-07-08 |
| 1710109509 | Joshua A Jacobi | Internal Medicine | 301 S Fair Oaks Ave Ste 404, Pasadena, CA 91105-2562 | 2007-05-03 |
| 1972624955 | Innovative Medical Solutions Inc A Medical Group | Internal Medicine | 14860 Roscoe Blvd Ste 200, Panorama City, CA 91402-4683 | 2007-04-03 |
| 1326101445 | Karen K.w. Kakishiba, M.d. Inc. | Internal Medicine | 810 Richland Rd, Yuba City, CA 95991-6200 | 2006-12-19 |
| 1518030543 | Lisa Law | Internal Medicine | 728 Pacific Ave Ste 302, San Francisco, CA 94133-4489 | 2006-11-16 |
| 1497844864 | Shigeki Fujitani | Internal Medicine | 6170 Canterbury Dr, Apt 222, Culver City, CA 90230-7929 | 2006-10-12 |
| 1982791562 | Rafayel Gevorkian | Internal Medicine | 5129 W Sunset Blvd, Los Angeles, CA 90027-5715 | 2006-10-06 |
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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.