Davon Dean

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ACSW102024 Issued in CA

Practice address

14677 Merrill Ave
Fontana, CA 92335-4219

Phone

(951) 643-2340

NPI assigned

Jul 28, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alondra Loya

  • Case Manager/Care Coordinator
  • Fontana, CA
  • NPI 1568160828
  NPD
• Olive Crest

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1215418165
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1154094886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9331",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924270331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14677 MERRILL AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354219",
            "telephone_number": "951-643-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "DAVON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW102024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Lynn De Roulet, MD
• Jessica Lara De Santiago, PSY.D.
• Flavia Mytilineos De Souza
• Aline J De Vera, PHARM.D.
• Arif Dean, P.T.
• Alma Rosa Deaquino
• Phyllip R Dedden, PHARM.D.
• Bunthan Dee, D.P.M
• Clarissa Lloren Dee, PHARMD
• Definition Sports Massage Inc.

• Mental Health Counselor in Fontana, CA
• Providers in Fontana, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.