Healthcare Provider Details

I. General information

NPI: 1942811385
Provider Name (Legal Business Name): RONALD SWARTZ PH.D., LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E ST STE 208
EUREKA CA
95501-0378
US

IV. Provider business mailing address

350 E ST STE 208
EUREKA CA
95501-0378
US

V. Phone/Fax

Practice location:
  • Phone: 707-832-2111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW20249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: