Provider Demographics
NPI:1023216066
Name:DEAN, DEBORAH M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:M
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 ROLAND DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-1057
Mailing Address - Country:US
Mailing Address - Phone:510-390-6123
Mailing Address - Fax:510-601-3994
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-390-6123
Practice Address - Fax:510-601-3994
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207641041C0700X
CA20674282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No282NC2000XHospitalsGeneral Acute Care HospitalChildren