Provider Demographics
NPI:1356067672
Name:SWEAT, RYAN MATTHEW (LMFT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MATTHEW
Last Name:SWEAT
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2433
Mailing Address - Country:US
Mailing Address - Phone:650-766-0406
Mailing Address - Fax:
Practice Address - Street 1:10054 CAMBRIDGE BLUE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7718
Practice Address - Country:US
Practice Address - Phone:510-519-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist