Provider Demographics
NPI:1063266401
Name:FRENCH, DEANNA
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:FRENCH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40234 BENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-1618
Mailing Address - Country:US
Mailing Address - Phone:951-760-6401
Mailing Address - Fax:
Practice Address - Street 1:506 W GRAHAM AVE STE 106
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-3665
Practice Address - Country:US
Practice Address - Phone:951-459-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CAMPSS-CAYEUG175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker