Healthcare Provider Details

I. General information

NPI: 1528106036
Provider Name (Legal Business Name): CARY FRANK SCHWIMMER PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15055 VISTA ROAD #5, BOX 567
HELENDALE CA
92342
US

IV. Provider business mailing address

569 N ROSSMORE AVE APT 402
LOS ANGELES CA
90004-2446
US

V. Phone/Fax

Practice location:
  • Phone: 954-478-0400
  • Fax: 323-543-9247
Mailing address:
  • Phone: 954-478-0400
  • Fax: 323-543-9247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberFLPY5736
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberCA PY 27145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: