Provider Demographics
NPI:1720163124
Name:UCHALIK, DEBORAH CATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CATHERINE
Last Name:UCHALIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71477 ESTELLITA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4214
Mailing Address - Country:US
Mailing Address - Phone:760-346-4330
Mailing Address - Fax:760-341-3774
Practice Address - Street 1:42370 RANCHO LAS PALMAS DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4371
Practice Address - Country:US
Practice Address - Phone:760-346-4330
Practice Address - Fax:760-341-3774
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6784103G00000X
COPSY6784103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL67840Medicare ID - Type UnspecifiedPROVIDER NUMBER