Provider Demographics
NPI:1912069782
Name:BAUER, DEBRA LEE (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:BAUER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 MORELLO AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1824
Mailing Address - Country:US
Mailing Address - Phone:925-437-2203
Mailing Address - Fax:925-944-1195
Practice Address - Street 1:2255 MORELLO AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1824
Practice Address - Country:US
Practice Address - Phone:925-437-2203
Practice Address - Fax:925-944-1195
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 43512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist