Healthcare Provider Details

I. General information

NPI: 1033590856
Provider Name (Legal Business Name): DEBRA MARIE CALIFIA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 MORRO RD. AEGIS TREATMENT CENTERS
ATASCADERO CA
93422
US

IV. Provider business mailing address

5740 OLMEDA AVE
ATASCADERO CA
93422-3481
US

V. Phone/Fax

Practice location:
  • Phone: 805-461-5212
  • Fax:
Mailing address:
  • Phone: 860-488-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: