Provider Demographics
NPI:1053681361
Name:SCHWIMMER, WILLIAM LENARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LENARD
Last Name:SCHWIMMER
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 1:11250 BARNETT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-9555
Mailing Address - Country:US
Mailing Address - Phone:707-829-8566
Mailing Address - Fax:
Practice Address - Street 1:11250 BARNETT VALLEY RD
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-9555
Practice Address - Country:US
Practice Address - Phone:707-829-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical