MEDICARE: DEBORAH C LUPTON LMFT

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	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MFT17937	CA

General Provider Information

NPI Number	:	1609331073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH C LUPTON LMFT

Provider Business Mailing Address
First Line	:	51 RENATO CT STE A
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-4017
Country	:	US
Telephone Number	:	650-365-6502
Fax Number	:	650-365-4460

Provider Business Practice Location Address
First Line	:	51 RENATO CT STE A
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-4017
Country	:	US
Telephone Number	:	650-365-6502
Fax Number	:	650-365-4460

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

Provider Enumeration Date	:	02/09/2019
Last Update Date	:	02/09/2019

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