Basic Information
Provider Information
NPI: 1811045990
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNLAP
FirstName: GENEVIEVE
MiddleName: LOUISE
NamePrefix: MS.
NameSuffix:  
Credential: CADCII
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: AREIAS
OtherFirstName: GENEVIEVE
OtherMiddleName: LOUISE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 2087
Address2:  
City: MERCED
State: CA
PostalCode: 953440087
CountryCode: US
TelephoneNumber: 2093816850
FaxNumber: 2093853174
Practice Location
Address1: 301 E 13TH ST
Address2:  
City: MERCED
State: CA
PostalCode: 953416211
CountryCode: US
TelephoneNumber: 2093816850
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/08/2007
LastUpdateDate: 05/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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