Basic Information
| Provider Information | |||||||||
| NPI: | 1972649317 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWARINGEN | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | NGOCPHAM | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N MAIN ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927013640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144806767 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1200 N MAIN ST | ||||||||
| Address2: | SUITE #200 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927013640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144806767 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 11/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW 20297 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | 71554 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.