Provider Demographics
NPI:1073856407
Name:SWIER, CRISTA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CRISTA
Middle Name:MARIE
Last Name:SWIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 CORNERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-9493
Mailing Address - Country:US
Mailing Address - Phone:209-207-2286
Mailing Address - Fax:
Practice Address - Street 1:20606 S CARROLTON AVE
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9792
Practice Address - Country:US
Practice Address - Phone:209-207-2286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS271161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical