Provider Demographics
NPI:1235264953
Name:SWEENEY, THOMAS JOSEPH (NP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:38750 POMO CT
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-7047
Mailing Address - Country:US
Mailing Address - Phone:909-558-3424
Mailing Address - Fax:909-558-3023
Practice Address - Street 1:11234 ANDERSON ST STE 1516E
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4909
Practice Address - Fax:909-558-0428
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2020-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA497347363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health