Provider Demographics
NPI:1699198341
Name:DAWSON-JESUS, DEANNA MARIE (CD, CLE)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:DAWSON-JESUS
Suffix:
Gender:F
Credentials:CD, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22535 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3005
Mailing Address - Country:US
Mailing Address - Phone:925-216-7264
Mailing Address - Fax:
Practice Address - Street 1:22535 6TH ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3005
Practice Address - Country:US
Practice Address - Phone:925-216-7264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Yes374J00000XNursing Service Related ProvidersDoula