Provider Demographics
NPI:1669919346
Name:PEREZ, DEBORAH (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DEERWOOD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4445
Mailing Address - Country:US
Mailing Address - Phone:925-270-4499
Mailing Address - Fax:925-270-4499
Practice Address - Street 1:111 DEERWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4445
Practice Address - Country:US
Practice Address - Phone:925-270-4499
Practice Address - Fax:925-270-4499
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107912106H00000X
390200000X
CALMFT132357106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program