Provider Demographics
NPI:1811593353
Name:HALLETT, DEBORAH MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:HALLETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:534 E PINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5536
Mailing Address - Country:US
Mailing Address - Phone:209-463-5800
Mailing Address - Fax:209-463-5900
Practice Address - Street 1:2357 W MARCH LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5239
Practice Address - Country:US
Practice Address - Phone:209-477-9300
Practice Address - Fax:209-477-9400
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist