Provider Demographics
NPI:1528857547
Name:MITCHELL, VIVIAN DOROTHY (DSW, LCSW, MSW)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:DOROTHY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DSW, LCSW, MSW
Other - Prefix:MS
Other - First Name:VIVIAN
Other - Middle Name:DOROTHY
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9065
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-9065
Mailing Address - Country:US
Mailing Address - Phone:707-712-2905
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 9065
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-9065
Practice Address - Country:US
Practice Address - Phone:707-712-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1293641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical