Provider Demographics
NPI:1477000875
Name:PASTOR, DARA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:MARIE
Last Name:PASTOR
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 1:3780 ROSIN CT STE 110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1698
Mailing Address - Country:US
Mailing Address - Phone:916-441-0226
Mailing Address - Fax:916-441-0286
Practice Address - Street 1:3780 ROSIN CT STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1698
Practice Address - Country:US
Practice Address - Phone:916-417-5737
Practice Address - Fax:916-441-6377
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA1010291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker