Healthcare Provider Details

I. General information

NPI: 1265252878
Provider Name (Legal Business Name): SOFIA MARGARITA SWATT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 DAWN HILL RD
GLEN ELLEN CA
95442-9704
US

IV. Provider business mailing address

1234 CAMBRIDGE DR
LAFAYETTE CA
94549-2936
US

V. Phone/Fax

Practice location:
  • Phone: 925-899-9668
  • Fax:
Mailing address:
  • Phone: 925-899-9668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number11814509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: