Provider Demographics
NPI:1437332889
Name:SAMS, DEBORAH (RN, PHN, PNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SAMS
Suffix:
Gender:F
Credentials:RN, PHN, PNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:SAMS-USATIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:440 BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1325
Mailing Address - Country:US
Mailing Address - Phone:925-313-6615
Mailing Address - Fax:925-313-6465
Practice Address - Street 1:597 CENTER AVE
Practice Address - Street 2:200A
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4640
Practice Address - Country:US
Practice Address - Phone:925-313-6615
Practice Address - Fax:925-313-6465
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA266584163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management