Healthcare Provider Details

I. General information

NPI: 1821154865
Provider Name (Legal Business Name): PAMELA DIXON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BECK AVE MSC 5-240
FAIRFIELD CA
94533-6804
US

IV. Provider business mailing address

7512 DRY CREEK TRL
VACAVILLE CA
95688-9509
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-8084
  • Fax: 707-438-2500
Mailing address:
  • Phone: 707-784-8084
  • Fax: 707-438-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number520741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: