MEDICARE: MR. ALEN SCHWAB LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	191715	CA
2	106H00000X	Marriage & Family Therapist	AMFT110099	CA
3	106H00000X	Marriage & Family Therapist	135187	CA

General Provider Information

NPI Number	:	1649740226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEN SCHWAB LMFT

Provider Business Mailing Address
First Line	:	720 SOUTHPOINT BLVD STE 202
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94954-8017
Country	:	US
Telephone Number	:	707-999-3920
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 SOUTHPOINT BLVD STE 202
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94954-8017
Country	:	US
Telephone Number	:	707-999-3920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	06/05/2026

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