Provider Demographics
NPI:1639469802
Name:TATE, DEBORAH KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:TATE
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 1:2970 CAMINO DIABLO STE 100
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-4001
Mailing Address - Country:US
Mailing Address - Phone:650-348-6603
Mailing Address - Fax:650-348-0615
Practice Address - Street 1:2970 CAMINO DIABLO STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-4001
Practice Address - Country:US
Practice Address - Phone:650-348-6603
Practice Address - Fax:650-348-0615
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 206641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20664OtherLCSW
CA20664OtherBOARD OF BEHAVIORAL SCIENCES