Healthcare Provider Details

I. General information

NPI: 1265631311
Provider Name (Legal Business Name): MR. DEON LAMONTE PRICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W AVENUE J SUIT C
LANCASTER CA
93534-3443
US

IV. Provider business mailing address

42216 MARBELLA ST
QUARTZ HILL CA
93536-3440
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-0131
  • Fax:
Mailing address:
  • Phone: 818-402-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: