Provider Demographics
NPI:1336505874
Name:RIBERA, DEBORAH (MFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:RIBERA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60616
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6616
Mailing Address - Country:US
Mailing Address - Phone:415-294-1282
Mailing Address - Fax:
Practice Address - Street 1:975 SAN PASQUAL ST APT 119
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3314
Practice Address - Country:US
Practice Address - Phone:415-294-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79648106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist