Provider Demographics
NPI:1326444944
Name:DUNN, JENNY (BCABA)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 EUREKA RD
Mailing Address - Street 2:SUITE 155-2
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7720
Mailing Address - Country:US
Mailing Address - Phone:916-761-5315
Mailing Address - Fax:
Practice Address - Street 1:1700 EUREKA RD
Practice Address - Street 2:SUITE 155-2
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7720
Practice Address - Country:US
Practice Address - Phone:916-761-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst