Provider Demographics
NPI:1679905590
Name:DEAN, GWENDOLYN ALDEN (LCSW)
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:ALDEN
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GWENDOLYN
Other - Middle Name:ALDEN
Other - Last Name:HAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2751 NAPA VALLEY CORPORATE DR STE A211
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6216
Mailing Address - Country:US
Mailing Address - Phone:707-259-8193
Mailing Address - Fax:707-265-4717
Practice Address - Street 1:2751 NAPA VALLEY CORPORATE DR STE A211
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6216
Practice Address - Country:US
Practice Address - Phone:707-259-8193
Practice Address - Fax:707-265-4717
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA811961041C0700X
CA624591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical