Provider Demographics
NPI:1447381462
Name:SWANSON, AUSTIN CHRISTOPHER (MS)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:CHRISTOPHER
Last Name:SWANSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 HUGO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2510
Mailing Address - Country:US
Mailing Address - Phone:909-754-8577
Mailing Address - Fax:
Practice Address - Street 1:7 N KNOLL RD
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1663
Practice Address - Country:US
Practice Address - Phone:415-383-6633
Practice Address - Fax:415-383-6918
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7057237600000X
CAAU2405231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter