Provider Demographics
NPI:1013169390
Name:DEUTSCH, NANCY DARA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:DARA
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4406
Mailing Address - Country:US
Mailing Address - Phone:619-300-6069
Mailing Address - Fax:619-295-0540
Practice Address - Street 1:1238 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4406
Practice Address - Country:US
Practice Address - Phone:619-300-6069
Practice Address - Fax:619-295-0540
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS115471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical