Provider Demographics
NPI:1386807683
Name:SWEENEY, PAMELA CHRISTINA (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CHRISTINA
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:SWEENEY
Other - Last Name:WOODIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1330 LINCOLN AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2120
Mailing Address - Country:US
Mailing Address - Phone:415-455-5468
Mailing Address - Fax:
Practice Address - Street 1:1330 LINCOLN AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2120
Practice Address - Country:US
Practice Address - Phone:415-455-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist