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Dolores D. Mackinnon

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5625 College Ave, 207, Oakland, CA 94618-1585

PECOS Enrollment

Based on the most recent information from CMS, provider Dolores D. Mackinnon does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1851567952
Provider Type
Individual
Full Name
Mackinnon, Dolores D.
Title
Ms.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/8/2008
Last Updated
5/8/2008

Contact Information

Practice Location

5625 College Ave, 207, Oakland, CA 94618-1585

(510) 653-3540

Unlisted Fax

Mailing Location

5625 College Ave, 207, Oakland, CA 94618-1585

(510) 653-3540

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFC 9387 California

Provider Identifiers

ID	Description	Issuer
ID 4218413	Description Other	Issuer AETNA California

Dolores D. Mackinnon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Green, Monika

James Seishas Psychotherapy Lmft A Marriage And Family Therapy Corp

Mcgee, Brenna Kathryn Mchugh

Osterhold, Helge

Bowling, Sandra Kathleen

Porter Thompson Llc

Blumenfeld, Judy

Weglarz, Phillip M

Swedlow, Kara

Barokov, Julia M.