Provider Demographics
NPI:1093977563
Name:KATZ, DEBORAH E (PSY D)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:KATZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 JUTLAND DR
Mailing Address - Street 2:103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3663
Mailing Address - Country:US
Mailing Address - Phone:858-490-3460
Mailing Address - Fax:858-490-3462
Practice Address - Street 1:4241 JUTLAND DR
Practice Address - Street 2:103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3663
Practice Address - Country:US
Practice Address - Phone:858-490-3460
Practice Address - Fax:858-490-3462
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11493103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist