Provider Demographics
NPI:1659479756
Name:BROOKS, DEBORAH LYN (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYN
Last Name:BROOKS
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 1:68615 PEREZ RD
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7200
Mailing Address - Country:US
Mailing Address - Phone:760-770-2222
Mailing Address - Fax:760-770-2249
Practice Address - Street 1:68615 PEREZ RD
Practice Address - Street 2:SUITE 6A
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7200
Practice Address - Country:US
Practice Address - Phone:760-770-2222
Practice Address - Fax:760-770-2249
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS66601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical