MEDICARE: MS. DEBRA RENEE SINGLETON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9610	OTHER	CA	UBH

General Provider Information

NPI Number	:	1225149230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA RENEE SINGLETON

Provider Business Mailing Address
First Line	:	1840 WILSON AVE
Second Line	:	SUITE C
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-5515
Country	:	US
Telephone Number	:	619-952-9159
Fax Number	:	619-477-0799

Provider Business Practice Location Address
First Line	:	1840 WILSON AVE
Second Line	:	SUITE C
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-5515
Country	:	US
Telephone Number	:	619-952-9159
Fax Number	:	619-477-0799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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