Healthcare Provider Details

I. General information

NPI: 1255625273
Provider Name (Legal Business Name): EMILY TODD MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILLY SCHWARTZ MD, PHD

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 COURAGE DR
FAIRFIELD CA
94533-6717
US

IV. Provider business mailing address

1626 MONTANA AVE STE 621
SANTA MONICA CA
90403-1808
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-2080
  • Fax:
Mailing address:
  • Phone: 310-905-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301500415
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA123697
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301500415
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA123697
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME153218
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: