Provider Demographics
NPI:1790345551
Name:HUNT, DANA A
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:A
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 TROUVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2741
Mailing Address - Country:US
Mailing Address - Phone:805-458-6684
Mailing Address - Fax:
Practice Address - Street 1:969 TROUVILLE AVE
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2741
Practice Address - Country:US
Practice Address - Phone:805-458-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2025-02-05
Deactivation Date:2021-09-16
Deactivation Code:
Reactivation Date:2025-01-27
Provider Licenses
StateLicense IDTaxonomies
1-22-57985103K00000X
CO6103103T00000X
CAPSY35644103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst