Provider Demographics
NPI:1528118544
Name:FORESTER, DALENE (PHD)
Entity type:Individual
Prefix:
First Name:DALENE
Middle Name:
Last Name:FORESTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 PARK MARINA CIR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0965
Mailing Address - Country:US
Mailing Address - Phone:530-245-9221
Mailing Address - Fax:530-245-9222
Practice Address - Street 1:353 PARK MARINA CIR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0965
Practice Address - Country:US
Practice Address - Phone:530-245-9221
Practice Address - Fax:530-245-9222
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33095101YM0800X
CAMFC 33095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health