Provider Demographics
NPI:1386723450
Name:ACADEMY OF DEFENSIVE DRIVING
Entity type:Organization
Organization Name:ACADEMY OF DEFENSIVE DRIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-240-0115
Mailing Address - Street 1:31726 RANCHO VIEJO RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2779
Mailing Address - Country:US
Mailing Address - Phone:949-240-0115
Mailing Address - Fax:949-443-5018
Practice Address - Street 1:31726 RANCHO VIEJO RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2779
Practice Address - Country:US
Practice Address - Phone:949-240-0115
Practice Address - Fax:949-443-5018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3000301120251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management