Healthcare Provider Details

I. General information

NPI: 1982115572
Provider Name (Legal Business Name): DAWN HULL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 09/22/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 GLEN MOUNTAIN ROAD
BIG BEAR CITY CA
92314
US

IV. Provider business mailing address

PO BOX 2342
BIG BEAR CITY CA
92314-2342
US

V. Phone/Fax

Practice location:
  • Phone: 909-878-3228
  • Fax:
Mailing address:
  • Phone: 909-435-6847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW109222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: