Provider Demographics
NPI:1477741825
Name:FERRETTI, DEBRA (OTR/L CHT)
Entity Type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:
Last Name:FERRETTI
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 N TEXAS ST APT 115
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-7335
Mailing Address - Country:US
Mailing Address - Phone:707-419-4587
Mailing Address - Fax:
Practice Address - Street 1:336 ELM AVENUE
Practice Address - Street 2:#252
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:916-367-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6059172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker