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General NPI Number Information
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NPI Number | 1467097527
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Entity Type | Individual
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Provider Name | DENEANE HANNON
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Gender | Female
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 238 GEORGIA ST. STE 102
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City | VALLEJO
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State | CA
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Zip | 94590
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Country | US
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Telephone | 888-544-5553
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Fax |
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Provider Business Mailing Address
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Address Line | 5624 BARRETT AVE
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City | EL CERRITO
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State | CA
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Zip | 94530-1407
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Country | US
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Telephone | 415-286-3822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | CA
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