Provider Demographics
NPI:1497264956
Name:DUNN, STACY LORRAINE (BC-HIS)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:LORRAINE
Last Name:DUNN
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LORRAINE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1640 TEHAMA ST STE B
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1681
Mailing Address - Country:US
Mailing Address - Phone:530-243-7307
Mailing Address - Fax:530-243-1292
Practice Address - Street 1:1640 TEHAMA ST STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1681
Practice Address - Country:US
Practice Address - Phone:530-243-7307
Practice Address - Fax:530-243-1292
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA-7440237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist