Provider Demographics
NPI:1346129178
Name:ANDERSON, DAWN MICHELLE (RN)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MICHELLE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 REGENT ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-4553
Mailing Address - Country:US
Mailing Address - Phone:805-312-2609
Mailing Address - Fax:805-278-5016
Practice Address - Street 1:3400 W GONZALES RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-7768
Practice Address - Country:US
Practice Address - Phone:805-278-1853
Practice Address - Fax:805-278-5016
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489587163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool