Provider Demographics
NPI:1376535955
Name:DUNN, N. GENEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:N.
Middle Name:GENEAN
Last Name:DUNN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6965 EL CAMINO REAL STE 105 #463
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4101
Mailing Address - Country:US
Mailing Address - Phone:760-720-0272
Mailing Address - Fax:760-436-4748
Practice Address - Street 1:3150 EL CAMINO REAL
Practice Address - Street 2:STE E
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2110
Practice Address - Country:US
Practice Address - Phone:760-720-0272
Practice Address - Fax:760-436-4748
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5785103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY5785OtherSTATE LICENSE NUMBER
CA076303OtherMANAGED HEALTH NETWORK
CA00PL57850Medicaid
CAPSY5785OtherSTATE LICENSE NUMBER