Provider Demographics
NPI:1760186118
Name:CHAPMAN, DEAN RAYMOND
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:RAYMOND
Last Name:CHAPMAN
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 1:7249 LUCAS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NICASIO
Mailing Address - State:CA
Mailing Address - Zip Code:94946-9722
Mailing Address - Country:US
Mailing Address - Phone:608-419-1000
Mailing Address - Fax:
Practice Address - Street 1:7249 LUCAS VALLEY RD
Practice Address - Street 2:
Practice Address - City:NICASIO
Practice Address - State:CA
Practice Address - Zip Code:94946-9722
Practice Address - Country:US
Practice Address - Phone:608-419-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician