MEDICARE: KRISTIN DILLANE, LICENSED CLINICAL SOCIAL WORKER, P.C.

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1447858626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTIN DILLANE, LICENSED CLINICAL SOCIAL WORKER, P.C.

Provider Business Mailing Address
First Line	:	555 CAPITOL MALL SUITE 1150A
Second Line	:	PMB #CA117
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-1905
Country	:	US
Telephone Number	:	619-800-1734
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 14TH ST # CA117
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-1905
Country	:	US
Telephone Number	:	619-800-1734
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	KRISTIN DILLANE
Credential	:	LCSW
Telephone Number	:	619-800-1734

Provider Enumeration Date	:	10/11/2020
Last Update Date	:	05/22/2026

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