Provider Demographics
NPI:1194125302
Name:SWENSEN, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SWENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 41ST ST APT 202
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5217
Mailing Address - Country:US
Mailing Address - Phone:510-290-5218
Mailing Address - Fax:
Practice Address - Street 1:1900 POWELL ST STE 600
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1885
Practice Address - Country:US
Practice Address - Phone:855-760-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical