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General NPI Number Information
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NPI Number | 1245776681
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Entity Type | Individual
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Provider Name | DEBORAH LYNN WIELAND PSYD, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 10061 TALBERT AVE STE 200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5123
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Country | US
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Telephone | 714-408-3702
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Fax | 844-255-3511
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Provider Business Mailing Address
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Address Line | 214 PIGEON LN
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5726
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Country | US
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Telephone | 714-408-3702
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Fax | 844-255-3511
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT96864
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License Number State | CA
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