Provider Demographics
NPI:1013923077
Name:SWIDLER, EDYTHE JOYCE (MFT)
Entity Type:Individual
Prefix:MS
First Name:EDYTHE
Middle Name:JOYCE
Last Name:SWIDLER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8708 LAGUNA STAR DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6316
Mailing Address - Country:US
Mailing Address - Phone:916-548-1834
Mailing Address - Fax:
Practice Address - Street 1:7958 CARMENCITA AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-9444
Practice Address - Country:US
Practice Address - Phone:916-548-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30135106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist