Provider Demographics
NPI:1518332295
Name:SWENSON, CATHERINE ANN
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:SWENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2914
Mailing Address - Country:US
Mailing Address - Phone:805-543-3945
Mailing Address - Fax:805-543-6665
Practice Address - Street 1:1130 GROVE ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2914
Practice Address - Country:US
Practice Address - Phone:805-543-3945
Practice Address - Fax:805-543-6665
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43440911235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist