Provider Demographics
NPI:1255908430
Name:SWANBERG, SHARLENE (DC)
Entity type:Individual
Prefix:
First Name:SHARLENE
Middle Name:
Last Name:SWANBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37881 SPICEBUSH LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3579
Mailing Address - Country:US
Mailing Address - Phone:760-696-6070
Mailing Address - Fax:
Practice Address - Street 1:18025 CALLE AMBIENTE
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-9549
Practice Address - Country:US
Practice Address - Phone:858-367-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor