Provider Demographics
NPI:1194619957
Name:DIXON, AMBROSIA ROSE (MSW)
Entity type:Individual
Prefix:
First Name:AMBROSIA
Middle Name:ROSE
Last Name:DIXON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25190 CYPRESS AVE APT 323
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2217
Mailing Address - Country:US
Mailing Address - Phone:510-209-7999
Mailing Address - Fax:
Practice Address - Street 1:818 MAHLER RD
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1604
Practice Address - Country:US
Practice Address - Phone:650-591-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool