Healthcare Provider Details

I. General information

NPI: 1164555488
Provider Name (Legal Business Name): JOAN K DAWSON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31824 VILLAGE CENTER RD SUITE E
WESTLAKE VILLAGE CA
91361-4337
US

IV. Provider business mailing address

764 CORALTREE LN APT 254
OAK PARK CA
91377-5450
US

V. Phone/Fax

Practice location:
  • Phone: 818-991-1063
  • Fax: 818-991-1064
Mailing address:
  • Phone: 818-324-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN211395
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: