Provider Demographics
NPI:1578629192
Name:CHERNOW, DEBRA A (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:CHERNOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2262 WOODSIDE LN APT 1
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7451
Mailing Address - Country:US
Mailing Address - Phone:916-564-1031
Mailing Address - Fax:
Practice Address - Street 1:2829 WATT AVE # 150
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6237
Practice Address - Country:US
Practice Address - Phone:916-979-3532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS135481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical