Provider Demographics
NPI:1689892937
Name:WIMER, DEBRA MARIE
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:MARIE
Last Name:WIMER
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 1:5040 COMANCHE DR
Mailing Address - Street 2:APT 27
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3451
Mailing Address - Country:US
Mailing Address - Phone:619-697-7090
Mailing Address - Fax:
Practice Address - Street 1:5040 COMANCHE DR
Practice Address - Street 2:APT 27
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3451
Practice Address - Country:US
Practice Address - Phone:619-697-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator