Healthcare Provider Details

I. General information

NPI: 1821767583
Provider Name (Legal Business Name): COURTNEY FARRELL SWANSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST
OXNARD CA
93033-4560
US

IV. Provider business mailing address

2500 S C ST
OXNARD CA
93033-4560
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-9420
  • Fax: 805-385-9401
Mailing address:
  • Phone: 805-385-9420
  • Fax: 805-385-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: