MEDICARE: MS. CINDY L SWENSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS11986	CA

General Provider Information

NPI Number	:	1053334581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CINDY L SWENSON LCSW

Provider Business Mailing Address
First Line	:	PO BOX 66
Second Line	:
City	:	HERALD
State	:	CA
Zip	:	95638-0066
Country	:	US
Telephone Number	:	209-748-5634
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 ALBATROSS WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-2878
Country	:	US
Telephone Number	:	916-914-7237
Fax Number	:	916-914-7256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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