Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Sean Michael Dougherty, DPM

Individual provider Podiatrist · NPI 1407089261

Dr. Sean Michael Dougherty, DPM is a Podiatry in Fairfield, California. Qualified in 2009, 17 years ago. Practices with Jiva Health Inc, a 45-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2009
Specialties on file
4
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

1620 Pennsylvania Ave Ste A
Fairfield, CA 94533-3509
Phone: (707) 426-5644
Fax: (707) 426-3156
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence E5009 (CA)
Podiatrist Taxonomy 213E00000X · Licence E5009 (CA)
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X · Licence E5009 (CA)
Sports Medicine Podiatrist Taxonomy 213ES0000X · Licence E5009 (CA)

Record details

NPI number1407089261
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedAugust 27, 2009
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020
Mailing address1620 Pennsylvania Ave Ste A, Fairfield, CA 94533-3509

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Jiva Health Inc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fairfield