Provider Demographics
NPI:1184812596
Name:HAAVISTO, DAWN (LMFT)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:HAAVISTO
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 1:2291 W MARCH LN
Mailing Address - Street 2:BLDG. D, SUITE 200
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6652
Mailing Address - Country:US
Mailing Address - Phone:209-547-2468
Mailing Address - Fax:209-931-8695
Practice Address - Street 1:2291 W MARCH LN
Practice Address - Street 2:BLDG. D, SUITE 200
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6652
Practice Address - Country:US
Practice Address - Phone:209-547-2468
Practice Address - Fax:209-931-8695
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist