Provider Demographics
NPI:1356765820
Name:FLEMINGER, DAWN MARIE (BCABA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:FLEMINGER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SAINT PATRICKS DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5153
Mailing Address - Country:US
Mailing Address - Phone:510-414-7969
Mailing Address - Fax:
Practice Address - Street 1:135 SAINT PATRICKS DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5153
Practice Address - Country:US
Practice Address - Phone:510-414-7969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-13-5743103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst