Provider Demographics
NPI:1457093379
Name:DUNN, ASHLEE MARIE (RADT-I)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MARIE
Last Name:DUNN
Suffix:
Gender:F
Credentials:RADT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 KING ELDER CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5849
Mailing Address - Country:US
Mailing Address - Phone:916-770-0831
Mailing Address - Fax:
Practice Address - Street 1:1130 CONROY LN STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4154
Practice Address - Country:US
Practice Address - Phone:916-580-6600
Practice Address - Fax:916-580-6639
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1459720322101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)