Provider Demographics
NPI:1649502220
Name:PITKIN, DOROTHY C (LCSW, PHD)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:C
Last Name:PITKIN
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1012
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-1012
Mailing Address - Country:US
Mailing Address - Phone:650-400-8890
Mailing Address - Fax:
Practice Address - Street 1:1600 CALIFORNIA DR.
Practice Address - Street 2:CALIFORNIA MEDICAL FACILITY
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687
Practice Address - Country:US
Practice Address - Phone:707-448-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS242191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical