Provider Demographics
NPI:1902564032
Name:BELLINGER, DANA ELIZABETH
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ELIZABETH
Last Name:BELLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18205 ROSCOE BLVD APT 18
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4225
Mailing Address - Country:US
Mailing Address - Phone:530-356-2071
Mailing Address - Fax:
Practice Address - Street 1:233 E THOUSAND OAKS BOULEVARD
Practice Address - Street 2:100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-418-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst