Provider Demographics
NPI:1013360643
Name:SWEDLOW, KARA (PHD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:SWEDLOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 COLLEGE AVE STE 202-6
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1598
Mailing Address - Country:US
Mailing Address - Phone:415-937-1041
Mailing Address - Fax:
Practice Address - Street 1:5435 COLLEGE AVE STE 202-6
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1598
Practice Address - Country:US
Practice Address - Phone:415-937-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52221101YP2500X, 106H00000X
102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst