Provider Demographics
NPI:1225546914
Name:DUGAN, VINCENT MERCHOND (CCAPP)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:MERCHOND
Last Name:DUGAN
Suffix:
Gender:M
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 S LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1627
Mailing Address - Country:US
Mailing Address - Phone:213-880-8242
Mailing Address - Fax:
Practice Address - Street 1:1249 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1627
Practice Address - Country:US
Practice Address - Phone:323-592-3579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor