Provider Demographics
NPI:1821122367
Name:DIXON, ROSA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIE
Last Name:DIXON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38793
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-0793
Mailing Address - Country:US
Mailing Address - Phone:707-304-9577
Mailing Address - Fax:209-392-4557
Practice Address - Street 1:420 CLAIRE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-1502
Practice Address - Country:US
Practice Address - Phone:707-304-9577
Practice Address - Fax:209-392-4557
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132489106H00000X
CA71560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist