Provider Demographics
NPI:1952083933
Name:DIXON, LAUREN CAMILE (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CAMILE
Last Name:DIXON
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SHAFFER RD STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-5763
Mailing Address - Country:US
Mailing Address - Phone:831-400-6475
Mailing Address - Fax:831-466-9039
Practice Address - Street 1:1201 SHAFFER RD STE A
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-5763
Practice Address - Country:US
Practice Address - Phone:831-400-6475
Practice Address - Fax:831-466-9039
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health