Provider Demographics
NPI:1861506347
Name:SAYRE, DEBRA LYNN (MFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:SAYRE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 SHELLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7080
Mailing Address - Country:US
Mailing Address - Phone:408-559-5068
Mailing Address - Fax:
Practice Address - Street 1:100 GILMAN AVE STE C
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-3077
Practice Address - Country:US
Practice Address - Phone:408-376-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT30467101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health