Provider Demographics
NPI:1053349563
Name:BROWNSON, DEANNA (LCS 20780)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:BROWNSON
Suffix:
Gender:F
Credentials:LCS 20780
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1396
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92531-1396
Mailing Address - Country:US
Mailing Address - Phone:951-471-2503
Mailing Address - Fax:951-471-2503
Practice Address - Street 1:309 W HEALD AVE
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-3733
Practice Address - Country:US
Practice Address - Phone:951-471-2503
Practice Address - Fax:951-471-2503
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 207801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical