Healthcare Provider Details
I. General information
NPI: 1780242016
Provider Name (Legal Business Name): ANE HUNT-DUSSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2019
Last Update Date: 06/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 SNEATH LN STE 200
SAN BRUNO CA
94066-2349
US
IV. Provider business mailing address
2768 DELAWARE AVE
REDWOOD CITY CA
94061-3219
US
V. Phone/Fax
- Phone: 650-243-9849
- Fax:
- Phone: 650-235-5127
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: