Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dorene Fanning, LCSW

Individual provider Clinical Social Worker · NPI 1831523711

Dorene Fanning, LCSW is a Clinical Social Worker in Davis, California. Qualified in 2005, 21 years ago. Practices with Blue Moon Senior Counseling of California LLC, a 79-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2013
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2051 John Jones Rd
Davis, CA 95616-9701
Phone: (530) 753-3498
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCS29760 (CA)

Record details

NPI number1831523711
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 27, 2013
Last updated in NPPESAugust 27, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Blue Moon Senior Counseling Of California Llc — 79 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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