Individual provider Active NPI

Lynn N. Swanson, LMFT

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1013034149
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 30704 Issued in CA
Practice address
11573 Los Osos Valley Rd
Suite D
San Luis Obispo, CA 93405
Phone
(805) 541-1434
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC30407 CA
Marriage & Family Therapist 106H00000X MFC 30704 CA Primary

Addresses

Primary practice location

11573 Los Osos Valley Rd
Suite D
San Luis Obispo, CA 93405

Mailing address

11573 Los Osos Valley Rd
Suite D
San Luis Obispo, CA 93405
Phone (805) 473-3367

Other identifiers 1

IdentifierTypeStateIssuer
MFC30407OtherCAPROFESSIONAL LICENSE NUMB

Other names 1

  • Mrs. Lynn Nancy Swanson-Manzella Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 30704CAMDMarriage & Family Therapist
MFC30407CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1013034149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11573 LOS OSOS VALLEY RD",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-473-3367",
            "fax_number": "805-473-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11573 LOS OSOS VALLEY RD",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-541-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "LYNN",
        "middle_name": "N.",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC30407",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 30704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE NUMB",
            "identifier": "MFC30407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "SWANSON-MANZELLA",
            "middle_name": "NANCY",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.