Provider Demographics
NPI:1689936841
Name:SWANTON, JOANNA (OT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:SWANTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 24TH ST
Mailing Address - Street 2:APT E
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3754
Mailing Address - Country:US
Mailing Address - Phone:415-730-3919
Mailing Address - Fax:
Practice Address - Street 1:4021 24TH ST
Practice Address - Street 2:APT E
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3754
Practice Address - Country:US
Practice Address - Phone:415-730-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT12172174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist