Provider Demographics
NPI:1881305530
Name:DECKER, JAMES T (LCSW)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:DECKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:CAYUCOS
Mailing Address - State:CA
Mailing Address - Zip Code:93430-1507
Mailing Address - Country:US
Mailing Address - Phone:818-357-8876
Mailing Address - Fax:
Practice Address - Street 1:2959 RICHARD AVE
Practice Address - Street 2:
Practice Address - City:CAYUCOS
Practice Address - State:CA
Practice Address - Zip Code:93430-1507
Practice Address - Country:US
Practice Address - Phone:818-357-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW9715106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist