MEDICARE: DEANNA D. ALLEN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFT071050	CA

General Provider Information

NPI Number	:	1134154230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA D. ALLEN PH.D.

Provider Business Mailing Address
First Line	:	308 MAIN ST STE 1
Second Line	:
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-2529
Country	:	US
Telephone Number	:	530-265-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 MAIN ST STE 1
Second Line	:
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-2529
Country	:	US
Telephone Number	:	530-265-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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