Provider Demographics
NPI:1346714284
Name:CALDEIRA, DAWN KATHLEEN
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:KATHLEEN
Last Name:CALDEIRA
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 1:604 W OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6630
Mailing Address - Country:US
Mailing Address - Phone:805-862-8204
Mailing Address - Fax:805-969-9350
Practice Address - Street 1:604 W OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6630
Practice Address - Country:US
Practice Address - Phone:805-406-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)