Healthcare Provider Details

I. General information

NPI: 1255010898
Provider Name (Legal Business Name): NICKI DIANE DUNN-BECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7281 DUMOSA AVE STE 3&4
YUCCA VALLEY CA
92284-3769
US

IV. Provider business mailing address

7281 DUMOSA AVE STE 3&4
YUCCA VALLEY CA
92284-3769
US

V. Phone/Fax

Practice location:
  • Phone: 760-853-4755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149789
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: