Provider Demographics
NPI:1659150639
Name:STRAIGHT, DEON
Entity Type:Individual
Prefix:
First Name:DEON
Middle Name:
Last Name:STRAIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12750 VENTURA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2433
Mailing Address - Country:US
Mailing Address - Phone:323-839-9354
Mailing Address - Fax:
Practice Address - Street 1:5344 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:VALLEY VLG
Practice Address - State:CA
Practice Address - Zip Code:91607-2712
Practice Address - Country:US
Practice Address - Phone:818-730-3179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst