Provider Demographics
NPI:1609581198
Name:SWINEFORD, DELL LORRAINE (MENTAL HEALTH WORKER)
Entity Type:Individual
Prefix:
First Name:DELL
Middle Name:LORRAINE
Last Name:SWINEFORD
Suffix:
Gender:F
Credentials:MENTAL HEALTH WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11232 CREWE ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7802
Mailing Address - Country:US
Mailing Address - Phone:714-681-6741
Mailing Address - Fax:
Practice Address - Street 1:11401 BLOOMFIELD AVE BLDG 305-307
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-229-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist