| Doctor Name: | DENNIS RUNNER |
| NPI Number: | 1194933481 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 10751 Dale Ave Stanton, CA - 906802604 |
| Business Phone Number: | 7148215311 |
| Business Fax Number: | 7148216302 |
| Mailing Address: | 10751 Dale Ave, STANTON |
| State: | CA |
| Postal Code: | 906802604 |
| Phone Number: | 7148215311 |
| Fax Number: | 7148216302 |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |