Individual
DEIDRE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 DOYLE PARK DR STE 102, SANTA ROSA, CA 95405-4562
(707) 387-3922
(707) 523-0679
Mailing address
41 MALL RD, NEUROSURGERY DEPT, BURLINGTON, MA 01805-0001
(781) 744-7580
(781) 744-5778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA5692
MA
363A00000X
Physician Assistant
Primary
PA65505
CA
363AS0400X
Surgical Physician Assistant
—
MA
Other
Enumeration date
02/26/2016
Last updated
12/08/2025
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