Provider Demographics
NPI:1790989333
Name:HITZEMAN, DEBORAH ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:HITZEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17025 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-1731
Mailing Address - Country:US
Mailing Address - Phone:714-524-1357
Mailing Address - Fax:
Practice Address - Street 1:17451 BASTANCHURY RD
Practice Address - Street 2:SUITE 204 - 24
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-1857
Practice Address - Country:US
Practice Address - Phone:714-337-5663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41301106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist