Healthcare Provider Details
I. General information
NPI: 1629881412
Provider Name (Legal Business Name): SSWIGART INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27502 AMETHYST WAY
CASTAIC CA
91384-3166
US
IV. Provider business mailing address
PO BOX 83
CASTAIC CA
91310-0083
US
V. Phone/Fax
- Phone: 760-250-1195
- Fax: 760-205-8511
- Phone: 760-250-1195
- Fax: 760-205-8511
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHARON
MARIE
SWIGART
Title or Position: MARRIAGE & FAMILY THERAPIST, OWNER
Credential: LMFT
Phone: 760-250-1195