MEDICARE: DEDRA A HUNTER

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	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1336369917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEDRA A HUNTER

Provider Business Mailing Address
First Line	:	4082 BOSTON AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92113
Country	:	US
Telephone Number	:	619-527-2697
Fax Number	:

Provider Business Practice Location Address
First Line	:	3853 ROSECRANS ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-3115
Country	:	US
Telephone Number	:	619-692-8225
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	06/28/2026

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Directions to “ DEDRA A HUNTER ” Practice Location

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