Provider Demographics
NPI:1639450935
Name:BERBERICH, DEBORAH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:BERBERICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 N. JEFFERSON STREET
Mailing Address - Street 2:UNIT F
Mailing Address - City:ANAHEIM
Mailing Address - State:CO
Mailing Address - Zip Code:92807
Mailing Address - Country:US
Mailing Address - Phone:714-398-8491
Mailing Address - Fax:714-961-1512
Practice Address - Street 1:1210 N. JEFFERSON STREET
Practice Address - Street 2:UNIT F
Practice Address - City:ANAHEIM
Practice Address - State:CO
Practice Address - Zip Code:92807
Practice Address - Country:US
Practice Address - Phone:714-398-8491
Practice Address - Fax:714-961-1512
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17579103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical