Provider Demographics
NPI:1609082213
Name:REDMOND, DEBORAH ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:REDMOND
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:LICHTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:610 N PACIFIC ST APT 3
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-1951
Mailing Address - Country:US
Mailing Address - Phone:760-529-1313
Mailing Address - Fax:
Practice Address - Street 1:602 GARRISON ST STE 104
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-4865
Practice Address - Country:US
Practice Address - Phone:760-529-1313
Practice Address - Fax:215-713-0105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000289106H00000X
CALMFT30421106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist