Healthcare Provider Details

I. General information

NPI: 1275262164
Provider Name (Legal Business Name): LAUREN PATRICIA SWANSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCRIPPS DR STE 202
SACRAMENTO CA
95825-6206
US

IV. Provider business mailing address

5058 STONE CANYON DR
CASTRO VALLEY CA
94552-5517
US

V. Phone/Fax

Practice location:
  • Phone: 916-927-1114
  • Fax:
Mailing address:
  • Phone: 510-566-9406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61185
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: