Provider Demographics
NPI:1366005886
Name:MAY, DEBRA MARIE (PEER SPECIALIST-BHA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:MAY
Suffix:
Gender:F
Credentials:PEER SPECIALIST-BHA
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:MARIE
Other - Last Name:SEARCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:421 E MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-0437
Mailing Address - Country:US
Mailing Address - Phone:209-558-7494
Mailing Address - Fax:209-558-8918
Practice Address - Street 1:421 E MORRIS AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0437
Practice Address - Country:US
Practice Address - Phone:209-558-7494
Practice Address - Fax:209-558-8918
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAC0202543405300000X
CAMVLDCTZUJNKFHWRA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No405300000XOther Service ProvidersPrevention Professional