Individual provider Active NPI

Dawn Haavisto, LMFT

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1184812596
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
33799 Issued in CA
Practice address
2291 W March LN
BLDG. D, Suite 200
Stockton, CA 95207-6652
Phone
(209) 547-2468
Fax
(209) 931-8695
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 33799 CA Primary

Addresses

Primary practice location

2291 W March LN
BLDG. D, Suite 200
Stockton, CA 95207-6652

Mailing address

2291 W March LN
BLDG. D, Suite 200
Stockton, CA 95207-6652
Phone (209) 547-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251226000136 CA Practitioner - Marriage and Family Therapist 7810483005 Practice locations: Stockton, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2291 W March LN
Suite D200
Stockton, CA 95207-6670
Phone (209) 547-2468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindscape PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1184812596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 W MARCH LN",
            "address_2": "BLDG. D, SUITE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076652",
            "telephone_number": "209-547-2468",
            "fax_number": "209-931-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 W MARCH LN",
            "address_2": "BLDG. D, SUITE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076652",
            "telephone_number": "209-547-2468",
            "fax_number": "209-931-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAVISTO",
        "first_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "33799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.