Healthcare Provider Details

I. General information

NPI: 1952004269
Provider Name (Legal Business Name): BETH ANN SWITT CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W STATE ST STE 3B
REDLANDS CA
92373-4653
US

IV. Provider business mailing address

5463 OSBUN RD
SAN BERNARDINO CA
92404-2846
US

V. Phone/Fax

Practice location:
  • Phone: 909-991-4675
  • Fax:
Mailing address:
  • Phone: 909-855-7199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number69016
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: