Provider Demographics
NPI:1851545404
Name:FUJIMOTO, DEBORAH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:FUJIMOTO
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 1:3097 WILLOW AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4715
Mailing Address - Country:US
Mailing Address - Phone:559-908-8042
Mailing Address - Fax:559-908-8042
Practice Address - Street 1:3097 WILLOW AVE STE 8
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-4715
Practice Address - Country:US
Practice Address - Phone:559-908-8042
Practice Address - Fax:559-908-8042
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW793861041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical