Provider Demographics
NPI:1598279622
Name:LEMUS, DEBORAH S
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:LEMUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 BIRCH ST STE 3000
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2140
Mailing Address - Country:US
Mailing Address - Phone:424-202-0630
Mailing Address - Fax:949-576-3913
Practice Address - Street 1:5000 BIRCH ST STE 3000
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2140
Practice Address - Country:US
Practice Address - Phone:424-202-0630
Practice Address - Fax:949-576-3913
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80046101YM0800X, 1041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker