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NPI Code Detail

MEDICARE: NANCY ELIZABETH DEANDA

MEDICARE: NANCY ELIZABETH DEANDA
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 Analyst00004956CA

General Provider Information

NPI Number : 1538668579
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ELIZABETH DEANDA
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 1915 HOWARD RD STE B&C
Second Line :
City : MADERA
State : CA
Zip : 93637-5163
Country : US
Telephone Number : 559-330-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2018
Last Update Date : 02/05/2018

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Directions to “ NANCY ELIZABETH DEANDA ” Practice Location

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