Provider Demographics
NPI:1457490757
Name:SELL, DEBRA KAY (MFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:SELL
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 1:3501 LONE TREE WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6066
Mailing Address - Country:US
Mailing Address - Phone:925-427-8664
Mailing Address - Fax:925-427-8645
Practice Address - Street 1:3501 LONE TREE WAY
Practice Address - Street 2:STE 200
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94550-6066
Practice Address - Country:US
Practice Address - Phone:925-427-8664
Practice Address - Fax:925-427-8645
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist