Provider Demographics
NPI:1134976947
Name:DEBRA WARNER
Entity type:Organization
Organization Name:DEBRA WARNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-385-4175
Mailing Address - Street 1:27120 EUCALYPTUS AVE UNIT G117
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4543
Mailing Address - Country:US
Mailing Address - Phone:323-385-4175
Mailing Address - Fax:
Practice Address - Street 1:27120 EUCALYPTUS AVE UNIT G117
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4543
Practice Address - Country:US
Practice Address - Phone:323-385-4175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty