Healthcare Provider Details
I. General information
NPI: 1942428909
Provider Name (Legal Business Name): TRACEY ALAN SCHWEIZER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/23/2007
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 SOUTH DELACEY AVE SUITE 110
PASADENA CA
91105-2074
US
IV. Provider business mailing address
20216 ROSCOE BLVD UNIT 6
WINNETKA CA
91306-1686
US
V. Phone/Fax
- Phone: 626-395-7100
- Fax:
- Phone: 818-359-2895
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFC45336 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: