Provider Demographics
NPI:1033290234
Name:SWILLER, ARNOLD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:SWILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 LEMONA AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2009
Mailing Address - Country:US
Mailing Address - Phone:818-771-7781
Mailing Address - Fax:818-905-8317
Practice Address - Street 1:17000 VENTURA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4109
Practice Address - Country:US
Practice Address - Phone:818-771-7781
Practice Address - Fax:818-905-8317
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11880103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY 11880OtherPSYCHOLOGY LICENSE