Provider Demographics
NPI:1396954038
Name:WEITZMAN, DEBORAH MARGARET (CNM)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MARGARET
Last Name:WEITZMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1403 MALLARD WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3612
Mailing Address - Country:US
Mailing Address - Phone:408-749-8393
Mailing Address - Fax:408-749-8392
Practice Address - Street 1:2211 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1814
Practice Address - Country:US
Practice Address - Phone:650-574-2628
Practice Address - Fax:650-574-3894
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15055363LW0102X
CA1652367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health