Healthcare Provider Details

I. General information

NPI: 1841267960
Provider Name (Legal Business Name): DENISE LORA SWEENEY MEDICAL DOCTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6049 DOUGLAS BLVD STE 9
GRANITE BAY CA
95746-6249
US

IV. Provider business mailing address

6049 DOUGLAS BLVD STE 9
GRANITE BAY CA
95746-6249
US

V. Phone/Fax

Practice location:
  • Phone: 916-872-1172
  • Fax: 855-435-3153
Mailing address:
  • Phone: 916-872-1172
  • Fax: 916-872-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA79640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: