Provider Demographics
NPI:1962816504
Name:HEDWALL, DAWN FRANCES (LMFT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:FRANCES
Last Name:HEDWALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S EUCLID AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2446
Mailing Address - Country:US
Mailing Address - Phone:626-388-7935
Mailing Address - Fax:
Practice Address - Street 1:130 S EUCLID AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2446
Practice Address - Country:US
Practice Address - Phone:626-388-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT80077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist