Provider Demographics
NPI:1184827818
Name:DUNTON, DOREEN M (LVN,RAS)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:M
Last Name:DUNTON
Suffix:
Gender:F
Credentials:LVN,RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 MCMILLAN AVE
Mailing Address - Street 2:SUITE 136
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6766
Mailing Address - Country:US
Mailing Address - Phone:805-781-4786
Mailing Address - Fax:805-781-1227
Practice Address - Street 1:2945 MCMILLAN AVE
Practice Address - Street 2:SUITE 136
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6766
Practice Address - Country:US
Practice Address - Phone:805-781-4786
Practice Address - Fax:805-781-1227
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD0412241232101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor