Provider Demographics
NPI:1447962592
Name:DUNN, SIERRA (BSH-HS, LPN)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:BSH-HS, LPN
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:
Other - Last Name:BOWENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSH-HS, LPN
Mailing Address - Street 1:1760 DAVIDSON ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-1711
Mailing Address - Country:US
Mailing Address - Phone:323-630-5777
Mailing Address - Fax:
Practice Address - Street 1:1760 DAVIDSON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-1711
Practice Address - Country:US
Practice Address - Phone:323-630-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171400000X
171WH0202X, 103TP0016X, 172V00000X, 251E00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No251E00000XAgenciesHome Health