Provider Demographics
NPI:1427217793
Name:HARRISON, DEBORA LIZ (RCFE LICENCEE)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:LIZ
Last Name:HARRISON
Suffix:
Gender:F
Credentials:RCFE LICENCEE
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 59
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95919-0059
Mailing Address - Country:US
Mailing Address - Phone:530-675-3640
Mailing Address - Fax:
Practice Address - Street 1:8787 MYSTIC MINE TRAIL
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95919
Practice Address - Country:US
Practice Address - Phone:530-675-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARCFE# 5850020113747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant