Provider Demographics
NPI:1710016381
Name:VINALL, DEBORAH JOY (PSYD, MFT)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JOY
Last Name:VINALL
Suffix:
Gender:F
Credentials:PSYD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 C ST STE 204
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8305
Mailing Address - Country:US
Mailing Address - Phone:909-547-4878
Mailing Address - Fax:
Practice Address - Street 1:99 C ST STE 204
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-8305
Practice Address - Country:US
Practice Address - Phone:909-547-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF48304106H00000X
CAMFC45229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHS0087OtherMEDICAL