Provider Demographics
NPI:1861678740
Name:SWAYZE, DEBBIE J
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:J
Last Name:SWAYZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6991 N STATE ST
Mailing Address - Street 2:P.O. BOX 387, CALPELLA, CA 95418
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-9629
Mailing Address - Country:US
Mailing Address - Phone:707-467-5660
Mailing Address - Fax:707-485-5199
Practice Address - Street 1:6991 N STATE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-9629
Practice Address - Country:US
Practice Address - Phone:707-467-5660
Practice Address - Fax:707-485-5199
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAS0710011311101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator