Active NPI
Bryan C Dunn, MA, CHT
- Developmental Therapist
- Victorville, CA
National Provider Identifier
1962055426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 83-4587092
- Practice address
- 12180 Ridgecrest Rd Ste 508
Victorville, CA 92395-5903 - Phone
- (760) 985-8270
- NPI assigned
- Jul 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 83-4587092 | CA | Primary |
Addresses
Primary practice location
12180 Ridgecrest Rd Ste 508
Victorville, CA 92395-5903
Mailing address
11650 Chimayo Rd
Apple Valley, CA 92308-7700
Phone (760) 985-8270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83-4587092 | CA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1962055426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11650 CHIMAYO RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923087700",
"telephone_number": "760-985-8270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12180 RIDGECREST RD STE 508",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923955903",
"telephone_number": "760-985-8270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "BRYAN",
"middle_name": "C",
"credential": "MA, CHT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "CA",
"license": "83-4587092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.