Provider Demographics
NPI:1386834745
Name:WATSON, DENEEN LEO (MS LMFT, CADC-II)
Entity Type:Individual
Prefix:MR
First Name:DENEEN
Middle Name:LEO
Last Name:WATSON
Suffix:
Gender:M
Credentials:MS LMFT, CADC-II
Other - Prefix:
Other - First Name:DEAN
Other - Middle Name:LEO
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:615 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3138
Mailing Address - Country:US
Mailing Address - Phone:909-379-8217
Mailing Address - Fax:
Practice Address - Street 1:615 ROBIN CT
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3138
Practice Address - Country:US
Practice Address - Phone:909-379-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA94909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)