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NPI Code Detail

MEDICARE: MS. TINA DOLIN MSW

MEDICARE: MS. TINA DOLIN MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLSW18922CA

General Provider Information

NPI Number : 1174549869
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TINA DOLIN MSW
Provider Business Mailing Address
First Line : 1223 GAZELLE PL
Second Line :
City : DAVIS
State : CA
Zip : 95616-5716
Country : US
Telephone Number : 530-756-4661
Fax Number : 530-756-1368
Provider Business Practice Location Address
First Line : 1627 OAK AVE STE A
Second Line :
City : DAVIS
State : CA
Zip : 95616-1072
Country : US
Telephone Number : 530-756-0555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/08/2007

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Directions to “ MS. TINA DOLIN MSW” Practice Location

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