Individual
ETTA DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
4600 BROADWAY STE 1300, SACRAMENTO, CA 95820-1527
(916) 874-9597
(916) 874-1732
Mailing address
4600 BROADWAY STE 1300, SACRAMENTO, CA 95820-1527
(916) 874-9597
(916) 874-1732
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366513061
—
CA
Enumeration date
06/24/2010
Last updated
06/24/2010
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