Provider Demographics
NPI:1487823332
Name:DR. DUGAN AND ASSOCIATES
Entity Type:Organization
Organization Name:DR. DUGAN AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MANESS
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSY-D
Authorized Official - Phone:310-621-0335
Mailing Address - Street 1:122 LIME AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5158
Mailing Address - Country:US
Mailing Address - Phone:562-590-9905
Mailing Address - Fax:562-612-0015
Practice Address - Street 1:122 LIME AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5158
Practice Address - Country:US
Practice Address - Phone:562-590-9905
Practice Address - Fax:562-612-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty