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NPI Code Detail

MEDICARE: CHRISTINE DEEN

MEDICARE:   CHRISTINE  DEEN
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
1103K00000XBehavior Analyst1-20-43266CA

General Provider Information

NPI Number : 1538616404
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DEEN
Provider Business Mailing Address
First Line : 852 BRIDLE DR
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-1949
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1301 REDWOOD WAY STE 210
Second Line :
City : PETALUMA
State : CA
Zip : 94954-1134
Country : US
Telephone Number : 760-846-6558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 04/27/2026

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Directions to “ CHRISTINE DEEN ” Practice Location

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