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General NPI Number Information
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NPI Number | 1760661748
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Entity Type | Individual
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Provider Name | CAROL D. DECEW MS
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Gender | Female
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | PO BOX 210
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City | MONTCLAIR
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State | CA
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Zip | 91763-0210
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Country | US
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Telephone | 714-423-2485
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210
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City | MONTCLAIR
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State | CA
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Zip | 91763-0210
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Country | US
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Telephone | 714-432-2485
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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 | 79778
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 74212
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License Number State | CA
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