Provider Demographics
NPI:1851592547
Name:SWAFFORD, MILDRED ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MILDRED
Middle Name:ANN
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7038 SARONI DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1452
Mailing Address - Country:US
Mailing Address - Phone:510-667-3952
Mailing Address - Fax:510-667-3903
Practice Address - Street 1:2000 EMBARCADERO
Practice Address - Street 2:400
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5334
Practice Address - Country:US
Practice Address - Phone:510-667-3952
Practice Address - Fax:510-667-3903
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical