Provider Demographics
NPI:1770171035
Name:MOBLEY, DEBRA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:MOBLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:1226 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3232
Mailing Address - Country:US
Mailing Address - Phone:415-890-4324
Mailing Address - Fax:
Practice Address - Street 1:423 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4415
Practice Address - Country:US
Practice Address - Phone:415-890-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty