Theodore Earl Swigart IV, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19842 Issued in CA

Practice address

16465 Sierra Lakes Pkwy Ste 140
Fontana, CA 92336-1242

Phone

(909) 244-9593

Fax

(833) 903-0337

NPI assigned

Jun 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anthony Benigno, PSYD., Psychological Services, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fontana, CA
  • NPI 1295202943
  Medicare reassignment NPD

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1881188845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 140",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-244-9593",
            "fax_number": "833-903-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 140",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-244-9593",
            "fax_number": "833-903-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIGART",
        "first_name": "THEODORE",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dexa Jo Swanson, RPH
• Jon R Swanson, LCSW
• Scott Swartz, NP
• Sweetgrace Home Health Services, LLC
• Sweetgrace Home Health Services, LLC.
• Azeem Abdul Syed, PHARMD
• Azra Syed, MD
• Ibolya Szuromi, M.A.
• Hanieh Sadat Tabatabaei Yeganeh
• Yzabella Marie Tabirara, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.