Healthcare Provider Details

I. General information

NPI: 1235344375
Provider Name (Legal Business Name): DEBORAH KAY STUDEBAKER LMCPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH KAY GILBRIDE

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4813 EL CAMINO AVE SUITE A
CARMICHAEL CA
95608
US

IV. Provider business mailing address

4813 EL CAMINO AVE SUITE A
CARMICHAEL CA
95608
US

V. Phone/Fax

Practice location:
  • Phone: 707-738-8747
  • Fax: 916-978-9163
Mailing address:
  • Phone: 707-738-8747
  • Fax: 916-978-9163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: