Provider Demographics
NPI:1770791097
Name:YATES, DEBRA ROBIN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ROBIN
Last Name:YATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 DAVIS ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-2759
Mailing Address - Country:US
Mailing Address - Phone:510-481-4203
Mailing Address - Fax:510-481-4269
Practice Address - Street 1:500 DAVIS ST STE 120
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-2759
Practice Address - Country:US
Practice Address - Phone:510-481-4203
Practice Address - Fax:510-481-4269
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS20839104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker