Provider Demographics
NPI:1043447931
Name:DILLMAN, CAREN SUE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:SUE
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 DOUGLAS BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3897
Mailing Address - Country:US
Mailing Address - Phone:916-751-9347
Mailing Address - Fax:
Practice Address - Street 1:3300 DOUGLAS BLVD STE 190
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3897
Practice Address - Country:US
Practice Address - Phone:916-751-9347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist