Provider Demographics
NPI:1841058898
Name:MATTHEWS, DENNIS (SDVOBS)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:SDVOBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15361 BROOKHURST ST
Mailing Address - Street 2:APT 96
Mailing Address - City:WESTMINTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683
Mailing Address - Country:US
Mailing Address - Phone:949-394-3221
Mailing Address - Fax:
Practice Address - Street 1:12062 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1737
Practice Address - Country:US
Practice Address - Phone:949-394-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral