Healthcare Provider Details

I. General information

NPI: 1245145853
Provider Name (Legal Business Name): DEBORAH LINCOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5307 SEPULVEDA BLVD APT 305
SHERMAN OAKS CA
91411-3425
US

IV. Provider business mailing address

PO BOX 5213
SHERMAN OAKS CA
91413-5213
US

V. Phone/Fax

Practice location:
  • Phone: 310-795-1509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: