Provider Demographics
NPI:1023557519
Name:DUNAMIS CENTER INCORPORATED
Entity Type:Organization
Organization Name:DUNAMIS CENTER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHEPHERD PIERCY CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-338-0087
Mailing Address - Street 1:1465 VICTOR AVE STE B
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4856
Mailing Address - Country:US
Mailing Address - Phone:530-338-0087
Mailing Address - Fax:530-745-6053
Practice Address - Street 1:1465 VICTOR AVE STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4856
Practice Address - Country:US
Practice Address - Phone:530-338-0087
Practice Address - Fax:530-745-6053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82913101YM0800X, 106H00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty