Provider Demographics
NPI:1861609976
Name:MCDONALD, DEBORAH ANNE (MFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SEACAPE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94965
Mailing Address - Country:US
Mailing Address - Phone:415-388-4479
Mailing Address - Fax:415-388-5009
Practice Address - Street 1:39 SEACAPE DRIVE
Practice Address - Street 2:
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965
Practice Address - Country:US
Practice Address - Phone:415-388-4479
Practice Address - Fax:415-388-5009
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19031106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist