Provider Demographics
NPI:1669738217
Name:SWARTZ, LAUREL ALIZA (MFT)
Entity type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:ALIZA
Last Name:SWARTZ
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 1:11037 MONOGRAM AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5217
Mailing Address - Country:US
Mailing Address - Phone:818-681-2561
Mailing Address - Fax:
Practice Address - Street 1:11037 MONOGRAM AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5217
Practice Address - Country:US
Practice Address - Phone:818-681-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist