Provider Demographics
NPI:1366333072
Name:DEEGAN, MATTHEW J (MA, RBT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:J
Last Name:DEEGAN
Suffix:
Gender:M
Credentials:MA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21700 GOLDEN TRIANGLE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2954
Mailing Address - Country:US
Mailing Address - Phone:800-820-7813
Mailing Address - Fax:
Practice Address - Street 1:21700 GOLDEN TRIANGLE RD STE 201
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2954
Practice Address - Country:US
Practice Address - Phone:800-820-7813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-24-389674106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician