Basic Information
Provider Information
NPI: 1629122122
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNN
FirstName: ALANA
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 265 SAN JACINTO RIVER RD
Address2: SUITE 107
City: LAKE ELSINORE
State: CA
PostalCode: 925304400
CountryCode: US
TelephoneNumber: 9516749243
FaxNumber:  
Practice Location
Address1: 1105 E FLORIDA AVE STE 1105
Address2:  
City: HEMET
State: CA
PostalCode: 925434512
CountryCode: US
TelephoneNumber: 9514392939
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/22/2007
LastUpdateDate: 01/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X46090CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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