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Individual
KATHY GORDON-SWAN
Active
Individual
KATHY GORDON-SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
25100000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457646960
NPI
CA
01
—
414118
DMC
CA
Enumeration date
09/20/2016
Last updated
12/17/2019
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