Provider Demographics
NPI:1033356696
Name:WEBER, DEBORAH ANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANNE
Last Name:WEBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 WHITEHALL PL
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6140
Mailing Address - Country:US
Mailing Address - Phone:510-523-1002
Mailing Address - Fax:
Practice Address - Street 1:900 S ELISEO DR STE 202
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2153
Practice Address - Country:US
Practice Address - Phone:415-461-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-18
Last Update Date:2009-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276639363LF0000X
CA12311363LF0000X
CAMW0801200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily