Provider Demographics
NPI:1699358077
Name:DOLTON, BREA ARTIES
Entity Type:Individual
Prefix:MRS
First Name:BREA
Middle Name:ARTIES
Last Name:DOLTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BREA
Other - Middle Name:JALON
Other - Last Name:ARTIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535-1505
Mailing Address - Country:US
Mailing Address - Phone:504-909-5008
Mailing Address - Fax:
Practice Address - Street 1:354 CERNON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4502
Practice Address - Country:US
Practice Address - Phone:504-909-5008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician