Provider Demographics
NPI:1467796888
Name:PAXTON, TINA LEIGH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:LEIGH
Last Name:PAXTON
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 1:7448 ESTEEM DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-4336
Mailing Address - Country:US
Mailing Address - Phone:916-596-5261
Mailing Address - Fax:
Practice Address - Street 1:7448 ESTEEM DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95842-4336
Practice Address - Country:US
Practice Address - Phone:916-515-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692101041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical