Genise Marie Swain, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14833 Issued in CA

Practice address

731 El Cerrito PLZ
El Cerrito, CA 94530-4022

Phone

(510) 559-7975

NPI assigned

Apr 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Genise Marie Derosa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1740623867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 DEUCE CT",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301308",
            "telephone_number": "415-456-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 EL CERRITO PLZ",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945304022",
            "telephone_number": "510-559-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "GENISE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "14833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENISE",
            "last_name": "DEROSA",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Haeun Suh, DDS
• Beomsong Suh, D.D.S.
• Katie Sullivan, MED, CPPD
• Sara Lauren Kiehn Sullivan, FNP
• Naoko Sumii
• Debbie Swinarski, D.C.
• James Yoneo Tanaka, DDS
• Ted Satoshi Tanaka, D.P.M.
• Vivian Tang, D.D.S.
• Bella-Lisa Mia Teeling, M.A.-CCC, SP

• Physician Assistant in El Cerrito, CA
• Providers in El Cerrito, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.