Provider Demographics
NPI:1073641387
Name:DEWBERY, ANTOINNETTE MONIQUE
Entity Type:Individual
Prefix:
First Name:ANTOINNETTE
Middle Name:MONIQUE
Last Name:DEWBERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 BUSH ST STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5295
Mailing Address - Country:US
Mailing Address - Phone:415-346-2255
Mailing Address - Fax:844-946-0904
Practice Address - Street 1:1801 BUSH ST STE 114
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5295
Practice Address - Country:US
Practice Address - Phone:415-346-2255
Practice Address - Fax:415-346-2255
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health