Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 52221 | CA |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist |
NPI | 1013360643 |
---|---|
Provider Name | Kara Swedlow |
First Address | Oakland, CA 94618-1598 |
Second Address | Oakland, CA 94618-1598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2016 |
Last Update Date | 15/06/2020 |