Provider Demographics
NPI:1225223571
Name:DIMKE, JAMES CHARLES (MA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHARLES
Last Name:DIMKE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 VISTA DEL CAMINO CIR
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-2754
Mailing Address - Country:US
Mailing Address - Phone:831-521-9895
Mailing Address - Fax:
Practice Address - Street 1:200 CAMINO AGUAJITO STE 304
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3372
Practice Address - Country:US
Practice Address - Phone:831-521-9895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
CA133905106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health