Provider Demographics
NPI:1467910489
Name:LANDES, DEBORAH LYNN (CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:LANDES
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6536 QUAIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-7904
Mailing Address - Country:US
Mailing Address - Phone:530-768-5051
Mailing Address - Fax:530-605-2723
Practice Address - Street 1:1727 SOUTH ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1812
Practice Address - Country:US
Practice Address - Phone:530-768-5051
Practice Address - Fax:530-605-2723
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010933363LW0102X
CA235976367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health