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General NPI Number Information
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NPI Number | 1053003947
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Entity Type | Individual
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Provider Name | MIKARA DORSEY
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2335 AMERICAN RIVER DR STE 301
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City | SACRAMENTO
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State | CA
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Zip | 95825-7088
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Country | US
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Telephone | 530-648-0559
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Fax |
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Provider Business Mailing Address
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Address Line | 109 KIRKORIAN CT
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4556
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Country | US
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Telephone | 831-295-1108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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