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General NPI Number Information
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NPI Number | 1245845403
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Entity Type | Individual
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Provider Name | DEBORAH SUSAN ABBOTT LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 5905 SOQUEL DR STE 400
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City | SOQUEL
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State | CA
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Zip | 95073-2850
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Country | US
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Telephone | 831-345-1925
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PLUM ST SPC 14
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City | CAPITOLA
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State | CA
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Zip | 95010-2223
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Country | US
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Telephone | 831-345-1925
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Fax |
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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 | 27643
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License Number State | CA
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