Provider Demographics
NPI:1790940336
Name:DALTON, ARLENE DELVAULX (MFC)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:DELVAULX
Last Name:DALTON
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3089 C CLAIREMONT DRIVE
Mailing Address - Street 2:PMB #415
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6892
Mailing Address - Country:US
Mailing Address - Phone:619-296-6921
Mailing Address - Fax:
Practice Address - Street 1:3636 FOURTH AVENUE
Practice Address - Street 2:SUITE #205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4237
Practice Address - Country:US
Practice Address - Phone:619-296-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist