Healthcare Provider Details

I. General information

NPI: 1275468076
Provider Name (Legal Business Name): HANNAH DEZZANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 BRIDGEPORT ST
DANA POINT CA
92629-3257
US

IV. Provider business mailing address

84 BRIDGEPORT ST
DANA POINT CA
92629-3257
US

V. Phone/Fax

Practice location:
  • Phone: 757-355-7181
  • Fax:
Mailing address:
  • Phone: 757-355-7181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT163550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: