Healthcare Provider Details

I. General information

NPI: 1235340993
Provider Name (Legal Business Name): PATRICIA L. SWEETMAN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 CLOVIS AVE SUITE 104
CLOVIS CA
93612-1115
US

IV. Provider business mailing address

1446 N DE WOLF AVE
FRESNO CA
93727-9798
US

V. Phone/Fax

Practice location:
  • Phone: 559-930-2403
  • Fax: 559-255-7008
Mailing address:
  • Phone: 559-252-7685
  • Fax: 559-255-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS19353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: