Provider Demographics
NPI:1164104311
Name:RUMLEY, DEBORAH S (CH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:RUMLEY
Suffix:
Gender:F
Credentials:CH
Other - Prefix:MS
Other - First Name:DYLAN
Other - Middle Name:
Other - Last Name:RUMLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CH, MDH
Mailing Address - Street 1:4149A EL CAMINO WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306
Mailing Address - Country:US
Mailing Address - Phone:650-995-4082
Mailing Address - Fax:
Practice Address - Street 1:4149A EL CAMINO WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306
Practice Address - Country:US
Practice Address - Phone:650-995-4082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA$$$$$$$$$101200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist