Provider Demographics
NPI:1811135569
Name:DUPREE, DEBRA LEA (MFT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEA
Last Name:DUPREE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-2510
Mailing Address - Country:US
Mailing Address - Phone:619-417-9690
Mailing Address - Fax:619-923-3611
Practice Address - Street 1:4075 ALDER DR
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-2302
Practice Address - Country:US
Practice Address - Phone:619-417-9690
Practice Address - Fax:619-923-3611
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23250106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist