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General NPI Number Information
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NPI Number | 1902569478
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Entity Type | Individual
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Provider Name | ALYSS M. SWANSON REV.
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Gender | Female
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1760 THE ALAMEDA STE 100
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City | SAN JOSE
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State | CA
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Zip | 95126-1728
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Country | US
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Telephone | 408-391-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 11538 SUTTERS MILL CIR
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City | GOLD RIVER
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State | CA
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Zip | 95670-7205
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Country | US
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Telephone | 408-391-4268
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 128915
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License Number State | CA
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