Provider Demographics
NPI:1033372842
Name:BRANCATO, DEBRA MICHEL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:MICHEL
Last Name:BRANCATO
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 1:13 ORCHARD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8320
Mailing Address - Country:US
Mailing Address - Phone:949-837-3358
Mailing Address - Fax:949-837-0274
Practice Address - Street 1:13 ORCHARD
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8320
Practice Address - Country:US
Practice Address - Phone:949-837-3358
Practice Address - Fax:949-837-0274
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS146941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical