Provider Demographics
NPI:1326111832
Name:LEVINSKY, DEBRA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:A
Last Name:LEVINSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 ELMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2326
Mailing Address - Country:US
Mailing Address - Phone:925-283-5800
Mailing Address - Fax:925-284-8115
Practice Address - Street 1:3466 MT DIABLO BLVD
Practice Address - Street 2:SUITE C100
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-7106
Practice Address - Country:US
Practice Address - Phone:925-283-5800
Practice Address - Fax:925-284-8115
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG376840174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G376840Medicaid
CA00G376840Medicare ID - Type Unspecified
CAA47189Medicare UPIN