Organization
DR. ANNETTE SWAIN, A PSYCHOLOGICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNETTE M SWAIN PH.D. (PSYCHOLOGIST/OWNER)
(818) 385-0913
Entity
Organization
Contact information
Practice address
15928 VENTURA BLVD STE 231, ENCINO, CA 91436-4409
(818) 385-0913
(818) 385-1746
Mailing address
15928 VENTURA BLVD STE 231, ENCINO, CA 91436-4409
(818) 385-0913
(818) 385-1746
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
16330
CA
103TA0700X
Adult Development & Aging Psychologist
16330
CA
103TB0200X
Cognitive & Behavioral Psychologist
16330
CA
103TC0700X
Clinical Psychologist
16330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W21578
MEDICARE PTAN
CA
Enumeration date
10/24/2007
Last updated
02/23/2008
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