Healthcare Provider Details
I. General information
NPI: 1518365477
Provider Name (Legal Business Name): DEBORAH ANNE BREWER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/09/2014
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date: 03/31/2020
Reactivation Date: 06/25/2020
III. Provider practice location address
407 SHERMAN AVE STE C
PALO ALTO CA
94306-1872
US
IV. Provider business mailing address
1700 WEBSTER ST
PALO ALTO CA
94301-3853
US
V. Phone/Fax
- Phone: 650-461-9026
- Fax:
- Phone: 650-223-1952
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCSW78645 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LCSW78645 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: