Healthcare Provider Details

I. General information

NPI: 1598632903
Provider Name (Legal Business Name): MAKENZIE MARIE DEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 REFUGIO RD
GOLETA CA
93117-9778
US

IV. Provider business mailing address

236 ENTRANCE RD APT 10
GOLETA CA
93117-2775
US

V. Phone/Fax

Practice location:
  • Phone: 805-757-3548
  • Fax:
Mailing address:
  • Phone: 805-757-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: