Healthcare Provider Details

I. General information

NPI: 1093383929
Provider Name (Legal Business Name): DENEA HANRAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3944 MURPHY CANYON RD
SAN DIEGO CA
92123-4498
US

IV. Provider business mailing address

730 MEDICAL CENTER CT
CHULA VISTA CA
91911-6618
US

V. Phone/Fax

Practice location:
  • Phone: 858-278-2847
  • Fax:
Mailing address:
  • Phone: 619-421-6979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: