Provider Demographics
NPI:1871557421
Name:STEELE, DENNIS D (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:D
Last Name:STEELE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17215 STUDEBAKER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2548
Mailing Address - Country:US
Mailing Address - Phone:562-924-7307
Mailing Address - Fax:562-860-9398
Practice Address - Street 1:17215 STUDEBAKER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2548
Practice Address - Country:US
Practice Address - Phone:562-924-7307
Practice Address - Fax:562-860-9398
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4331103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY043310Medicaid
CAR25721Medicare UPIN
CACP4331Medicare ID - Type UnspecifiedGROUP
CAPSY043310Medicaid