Healthcare Provider Details

I. General information

NPI: 1821906819
Provider Name (Legal Business Name): ROBERT THOMAS SWAYZE-TEXCA OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 E HARDING WAY
STOCKTON CA
95205-3572
US

IV. Provider business mailing address

2727 E HARDING WAY
STOCKTON CA
95205-3572
US

V. Phone/Fax

Practice location:
  • Phone: 209-513-4276
  • Fax:
Mailing address:
  • Phone: 209-513-4276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28708
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: