Provider Demographics
NPI:1265252878
Name:SWATT, SOFIA MARGARITA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:MARGARITA
Last Name:SWATT
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 1:1234 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2936
Mailing Address - Country:US
Mailing Address - Phone:925-899-9668
Mailing Address - Fax:
Practice Address - Street 1:1359 DAWN HILL RD
Practice Address - Street 2:
Practice Address - City:GLEN ELLEN
Practice Address - State:CA
Practice Address - Zip Code:95442-9704
Practice Address - Country:US
Practice Address - Phone:925-899-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty