Provider Demographics
NPI:1912880220
Name:SWALLOWS, SUNNY VALENTINE
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:VALENTINE
Last Name:SWALLOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 ROCKAWAY RD
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-9306
Mailing Address - Country:US
Mailing Address - Phone:805-275-8350
Mailing Address - Fax:
Practice Address - Street 1:158 ROCKAWAY RD
Practice Address - Street 2:
Practice Address - City:OAK VIEW
Practice Address - State:CA
Practice Address - Zip Code:93022-9306
Practice Address - Country:US
Practice Address - Phone:805-275-8350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1610830525106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician