Provider Demographics
NPI:1710292750
Name:MCNEIL, DEBORAH SARVIS
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SARVIS
Last Name:MCNEIL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4062
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94913-4062
Mailing Address - Country:US
Mailing Address - Phone:415-328-5970
Mailing Address - Fax:
Practice Address - Street 1:33 CLUB VIEW DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6821
Practice Address - Country:US
Practice Address - Phone:415-328-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84744106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist