Annie Sweetnam, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14383 Issued in CA

Practice address

4236 Edge Drive
Oakland, CA 94602

Phone

(510) 531-5212

Fax

(510) 531-7284

NPI assigned

Oct 15, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2015 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1255641833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4236 EDGE DRIVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94602",
            "telephone_number": "510-531-5212",
            "fax_number": "510-531-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4236 EDGE DRIVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94602",
            "telephone_number": "510-531-5212",
            "fax_number": "510-531-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEETNAM",
        "first_name": "ANNIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14383",
            "primary": true
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CA",
            "license": "PSY14383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Sweeney
• Nicolette Sweeney, RN
• Diana D. Sweet, MD
• La Sonyanette Sweet
• Nancy K Sweeters, RN, PNP
• Patricia Ann Sweetwine, MSW, MPH
• Kalayha Sweetwyne
• Judi A Swenson, NP
• Kristina Swenston, RN
• Eraina Swift

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.