Provider Demographics
NPI:1245776681
Name:WIELAND, DEBORAH LYNN (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:WIELAND
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 PIGEON LN
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5726
Mailing Address - Country:US
Mailing Address - Phone:714-408-3702
Mailing Address - Fax:844-255-3511
Practice Address - Street 1:10061 TALBERT AVE STE 200
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5123
Practice Address - Country:US
Practice Address - Phone:714-408-3702
Practice Address - Fax:844-255-3511
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT96864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist