Provider Demographics
NPI:1336474097
Name:CONSIGLIO, DEBRA LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LEE
Last Name:CONSIGLIO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 CARBON CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2342
Mailing Address - Country:US
Mailing Address - Phone:714-792-2825
Mailing Address - Fax:
Practice Address - Street 1:11001 VALLEY MALL
Practice Address - Street 2:SUITE 300
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2620
Practice Address - Country:US
Practice Address - Phone:626-442-0710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAICAN874OtherLA COUNTY DMH