Healthcare Provider Details

I. General information

NPI: 1619492543
Provider Name (Legal Business Name): KRISTIN SCHWARTZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10620 TREENA ST STE 230
SAN DIEGO CA
92131-1140
US

IV. Provider business mailing address

5151 E BROADWAY BLVD STE 1600
TUCSON AZ
85711-3777
US

V. Phone/Fax

Practice location:
  • Phone: 619-800-3574
  • Fax:
Mailing address:
  • Phone: 520-276-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4877
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY31866
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY31866
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4877
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4877
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31866
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY31866
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number4877
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: