Provider Demographics
NPI:1477958734
Name:DUNAGAN, KRISTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:DUNAGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11271
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-5024
Mailing Address - Country:US
Mailing Address - Phone:949-229-0125
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 11271
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92658-5024
Practice Address - Country:US
Practice Address - Phone:714-229-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2024-04-25
Deactivation Date:2016-01-15
Deactivation Code:
Reactivation Date:2018-08-24
Provider Licenses
StateLicense IDTaxonomies
CAASW631271041C0700X
CALCSW806451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical