Provider Demographics
NPI:1174632228
Name:DIXON, YVETTE ELIZABETH (MFT/IMF)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:ELIZABETH
Last Name:DIXON
Suffix:
Gender:F
Credentials:MFT/IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8751 DOVE TREE LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6791
Mailing Address - Country:US
Mailing Address - Phone:916-393-9326
Mailing Address - Fax:916-393-9726
Practice Address - Street 1:4612 ROSEVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5175
Practice Address - Country:US
Practice Address - Phone:916-344-0199
Practice Address - Fax:916-339-3029
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist