MEDICARE: MS. DEBRA P, DEANE M.A,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CA
2	101YM0800X	Mental Health Counselor	CA
3	103TA0700X	Adult Development & Aging Psychologist	CA
4	106H00000X	Marriage & Family Therapist	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487745204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA P, DEANE M.A,

Provider Business Mailing Address
First Line	:	3545 VALLEY RD
Second Line	:
City	:	BONITA
State	:	CA
Zip	:	91902-4163
Country	:	US
Telephone Number	:	619-470-0493
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 ADAMS AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-1403
Country	:	US
Telephone Number	:	619-283-5731
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	09/11/2025

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