Provider Demographics
NPI:1194785253
Name:SWENSEN, SOPHIA CHRISTINE (DOM, LMT)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:CHRISTINE
Last Name:SWENSEN
Suffix:
Gender:F
Credentials:DOM, LMT
Other - Prefix:MRS
Other - First Name:E. SOPHIA
Other - Middle Name:CHRISTINE
Other - Last Name:TREZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOM, LMT
Mailing Address - Street 1:6915 CALLE ALMERIA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1093
Mailing Address - Country:US
Mailing Address - Phone:505-345-3708
Mailing Address - Fax:505-344-9620
Practice Address - Street 1:6915 CALLE ALMERIA NE
Practice Address - Street 2:1620 INDIAN SCHOOL ROAD NE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1093
Practice Address - Country:US
Practice Address - Phone:505-345-9934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM773171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist