Provider Demographics
NPI:1568618395
Name:WEAVER, DEBORAH REGINA (BSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:REGINA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CONTRA COSTA ST
Mailing Address - Street 2:P.O. BOX 3069
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-6352
Mailing Address - Country:US
Mailing Address - Phone:707-644-6612
Mailing Address - Fax:707-644-7905
Practice Address - Street 1:400 CONTRA COSTA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-6352
Practice Address - Country:US
Practice Address - Phone:707-644-6612
Practice Address - Fax:707-644-7905
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management