Provider Demographics
NPI:1477655447
Name:DIXON, WHITNEY DEAUN (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:DEAUN
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MISSION RANCH BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2296
Mailing Address - Country:US
Mailing Address - Phone:530-899-9616
Mailing Address - Fax:530-899-9686
Practice Address - Street 1:145 MISSION RANCH BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2296
Practice Address - Country:US
Practice Address - Phone:530-899-9616
Practice Address - Fax:530-899-9686
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83663174400000X, 207VG0400X
AZ23982174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G836631OtherMEDICARE INDIVIDIAL ID
CAG23515Medicare UPIN
G23515Medicare UPIN
CAZZZ245702Medicare PIN