Healthcare Provider Details

I. General information

NPI: 1497825368
Provider Name (Legal Business Name): DEBORAH HUANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E. THOUSAND OAKS BLVD. SUITE 105
THOUSAND OAKS CA
91360-0000
US

IV. Provider business mailing address

115 LARKHILL ST
THOUSAND OAKS CA
91360-2832
US

V. Phone/Fax

Practice location:
  • Phone: 805-405-2804
  • Fax: 805-494-9357
Mailing address:
  • Phone: 805-300-0247
  • Fax: 805-494-9357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: