Provider Demographics
NPI:1427396431
Name:SWARTZ, NANCY JEAN
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:209 BEAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4141
Mailing Address - Country:US
Mailing Address - Phone:408-891-2399
Mailing Address - Fax:
Practice Address - Street 1:209 BEAN CREEK RD
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4141
Practice Address - Country:US
Practice Address - Phone:408-891-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF17042Medicare UPIN