Provider Demographics
NPI:1386847978
Name:DALE, ERIN COLLEEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:COLLEEN
Last Name:DALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 FAIRWAY OAKS CT
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-9357
Mailing Address - Country:US
Mailing Address - Phone:209-253-6767
Mailing Address - Fax:
Practice Address - Street 1:1673 FAIRWAY OAKS CT
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9357
Practice Address - Country:US
Practice Address - Phone:209-253-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA216331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical