Healthcare Provider Details

I. General information

NPI: 1740771757
Provider Name (Legal Business Name): NATASHA SWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date: 01/12/2026
Reactivation Date: 02/02/2026

III. Provider practice location address

1001 NEEDHAM ST
MODESTO CA
95354-0730
US

IV. Provider business mailing address

1001 NEEDHAM ST
MODESTO CA
95354-0730
US

V. Phone/Fax

Practice location:
  • Phone: 209-569-0373
  • Fax:
Mailing address:
  • Phone: 209-569-0373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: