Healthcare Provider Details

I. General information

NPI: 1366857054
Provider Name (Legal Business Name): MEGAN SWINFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2014
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11755 WILSHIRE BLVD STE 1250
LOS ANGELES CA
90025-1540
US

IV. Provider business mailing address

660 4TH ST STE 168
SAN FRANCISCO CA
94107-1618
US

V. Phone/Fax

Practice location:
  • Phone: 415-449-2813
  • Fax:
Mailing address:
  • Phone: 888-880-9270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: