Provider Demographics
NPI:1750645008
Name:ALLEN, DEBBIE (CPM, LM, CBE)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CPM, LM, CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 BOWLING GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2714
Mailing Address - Country:US
Mailing Address - Phone:310-686-7350
Mailing Address - Fax:
Practice Address - Street 1:426 BOWLING GREEN DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2714
Practice Address - Country:US
Practice Address - Phone:310-686-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAHEART&HANDS374J00000X
CA391176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374J00000XOtherNURSING SERVICE RELATED PROVIDERS