Healthcare Provider Details

I. General information

NPI: 1760736805
Provider Name (Legal Business Name): DR. ARON DEUTINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 01/03/2022
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 KING AVE
CORCORAN CA
93212-9611
US

IV. Provider business mailing address

5755 COTTLE RD
SAN JOSE CA
95123-3640
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-8800
  • Fax:
Mailing address:
  • Phone: 408-972-3095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 23164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: