Provider Demographics
NPI:1942348362
Name:JAYNES, DEBORAH L (MFC 23642)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:JAYNES
Suffix:
Gender:F
Credentials:MFC 23642
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:BIRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:518 S SCHOOL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5479
Mailing Address - Country:US
Mailing Address - Phone:707-467-0121
Mailing Address - Fax:
Practice Address - Street 1:518 S SCHOOL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5479
Practice Address - Country:US
Practice Address - Phone:707-467-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 23642106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist