Provider Demographics
NPI:1962825091
Name:DIXON, SAKARI
Entity Type:Individual
Prefix:
First Name:SAKARI
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5243
Mailing Address - Country:US
Mailing Address - Phone:909-793-1078
Mailing Address - Fax:909-335-7330
Practice Address - Street 1:205 E STATE ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5232
Practice Address - Country:US
Practice Address - Phone:909-793-1078
Practice Address - Fax:909-335-7330
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator