Provider Demographics
NPI:1093818742
Name:DAWSON, JANE ALICE (MFT)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ALICE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MFT
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 1215
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-1215
Mailing Address - Country:US
Mailing Address - Phone:831-425-3302
Mailing Address - Fax:
Practice Address - Street 1:35 MAGNIFICO VITA LN
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-0385
Practice Address - Country:US
Practice Address - Phone:831-425-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13845106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist