Provider Demographics
NPI:1457498263
Name:DOUWENGA, DEBRA J (ASSOCIATE MFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:DOUWENGA
Suffix:
Gender:F
Credentials:ASSOCIATE MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78045 CALLE BARCELONA
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253
Mailing Address - Country:US
Mailing Address - Phone:760-610-9650
Mailing Address - Fax:
Practice Address - Street 1:78045 CALLE BARCELONA
Practice Address - Street 2:SUITE 7
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253
Practice Address - Country:US
Practice Address - Phone:760-610-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist