Provider Demographics
NPI:1497873731
Name:KIRSCHBAUM, DEBORAH LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:KIRSCHBAUM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27001 LA PAZ RD
Mailing Address - Street 2:SUITE 418
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5502
Mailing Address - Country:US
Mailing Address - Phone:949-215-5400
Mailing Address - Fax:949-203-8686
Practice Address - Street 1:27001 LA PAZ RD
Practice Address - Street 2:SUITE 418
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5502
Practice Address - Country:US
Practice Address - Phone:949-215-5400
Practice Address - Fax:949-203-8686
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12070103TC0700X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst