Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 12805 | CA |
NPI | 1003079104 |
---|---|
Provider Name | Patricia Ann Sweetwine |
First Address | Oakland, CA 94608-2811 |
Second Address | Oakland, CA 94608-2811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 08/07/2008 |