Provider Demographics
NPI:1982768479
Name:SCHMIDT, DEBORAH K (PHD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 AUBURN RAVINE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3719
Mailing Address - Country:US
Mailing Address - Phone:530-888-0342
Mailing Address - Fax:530-888-1203
Practice Address - Street 1:251 AUBURN RAVINE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3719
Practice Address - Country:US
Practice Address - Phone:530-888-0342
Practice Address - Fax:530-888-1203
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14631103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6246729Medicare UPIN