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General NPI Number Information
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NPI Number | 1003039983
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Entity Type | Individual
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Provider Name | STEFFANIE SWENSON
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 101 E REDLANDS BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4775
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Country | US
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Telephone | 97-931-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 871 SAINT ANDREWS WAY
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City | BEAUMONT
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State | CA
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Zip | 92223-7192
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 2002 OT
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2002
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License Number State | CA
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