Provider Demographics
NPI:1205470382
Name:SWEETAN, VIRGINIA (ND)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:SWEETAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:
Other - Last Name:SWEETAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3262
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-3262
Mailing Address - Country:US
Mailing Address - Phone:858-914-3444
Mailing Address - Fax:
Practice Address - Street 1:16236 SAN DIEGUITO RD STE 4-15
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92091-9802
Practice Address - Country:US
Practice Address - Phone:858-914-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-01
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1114175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath