Provider Demographics
NPI:1487058616
Name:BATES, DEBORAH SUE (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:BATES
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 1:3060 VALENCIA AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4165
Mailing Address - Country:US
Mailing Address - Phone:831-460-2550
Mailing Address - Fax:831-688-1718
Practice Address - Street 1:3060 VALENCIA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4165
Practice Address - Country:US
Practice Address - Phone:831-460-2550
Practice Address - Fax:831-688-1718
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC52996106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist