Provider Demographics
NPI:1588248371
Name:BALDWIN, DAWNAE LINN
Entity type:Individual
Prefix:
First Name:DAWNAE
Middle Name:LINN
Last Name:BALDWIN
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 1:1008 WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7902
Mailing Address - Country:US
Mailing Address - Phone:916-761-2320
Mailing Address - Fax:
Practice Address - Street 1:2165 LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0600
Practice Address - Country:US
Practice Address - Phone:530-226-7419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC9535101YM0800X
CAAMFT125319101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health