Provider Demographics
NPI:1912521246
Name:WHITNEY, DEBORAH J (LMFT, #139267)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LMFT, #139267
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 SIERRA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4523
Mailing Address - Country:US
Mailing Address - Phone:805-440-7973
Mailing Address - Fax:
Practice Address - Street 1:676 PISMO ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3945
Practice Address - Country:US
Practice Address - Phone:805-543-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139267106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist