Provider Demographics
NPI:1407121627
Name:DAWSON, QUITA W (ACCBC 20011 CATC II)
Entity type:Individual
Prefix:
First Name:QUITA
Middle Name:W
Last Name:DAWSON
Suffix:
Gender:F
Credentials:ACCBC 20011 CATC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4408
Mailing Address - Country:US
Mailing Address - Phone:559-514-3767
Mailing Address - Fax:
Practice Address - Street 1:213 CENTER ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4408
Practice Address - Country:US
Practice Address - Phone:559-514-3767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20011373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist