Individual
MISS CASSANDRA LYNN DE VITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
275 BECK AVE # MS 5120, FAIRFIELD, CA 94533-6804
(707) 784-8065
Mailing address
275 BECK AVE # MS 5120, FAIRFIELD, CA 94533-6804
(707) 784-8065
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
ACSW97931
CA
101YM0800X
Mental Health Counselor
ASW64308
CA
104100000X
Social Worker
Primary
LCSW107775
CA
1041C0700X
Clinical Social Worker
LCSW107775
CA
Other
Enumeration date
08/26/2013
Last updated
05/26/2023
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