Provider Demographics
NPI:1003781113
Name:JARAMILLO-SWAFFORD, MARY T
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:JARAMILLO-SWAFFORD
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 1:8427 DUFFERS DR
Mailing Address - Street 2:
Mailing Address - City:PENRYN
Mailing Address - State:CA
Mailing Address - Zip Code:95663-9624
Mailing Address - Country:US
Mailing Address - Phone:916-584-1205
Mailing Address - Fax:916-993-8126
Practice Address - Street 1:1532 ROSALIND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-4535
Practice Address - Country:US
Practice Address - Phone:916-584-1205
Practice Address - Fax:916-993-8126
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker