Provider Demographics
NPI:1366640872
Name:MCMANUS, DEBORA HUGHES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:HUGHES
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2216
Mailing Address - Country:US
Mailing Address - Phone:415-260-1190
Mailing Address - Fax:925-935-2376
Practice Address - Street 1:3490 BUSKIRK AVE STE A
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4339
Practice Address - Country:US
Practice Address - Phone:415-260-1190
Practice Address - Fax:925-935-2376
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA189201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11713117OtherCAQH