Provider Demographics
NPI:1417094954
Name:DUNN, JOHN T (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:21812 PARVIN DR
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3041
Mailing Address - Country:US
Mailing Address - Phone:661-255-8715
Mailing Address - Fax:661-260-3329
Practice Address - Street 1:23734 VALENCIA BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-2100
Practice Address - Country:US
Practice Address - Phone:661-255-8715
Practice Address - Fax:661-260-3329
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY14454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP14454Medicare ID - Type Unspecified