MEDICARE: MS. DEBORAH J FOULKS

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1912033788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH J FOULKS

Provider Business Mailing Address
First Line	:	14412 TIARA ST
Second Line	:	APT. 5
City	:	VAN NUYS
State	:	CA
Zip	:	91401-3336
Country	:	US
Telephone Number	:	818-994-4205
Fax Number	:

Provider Business Practice Location Address
First Line	:	10605 BALBOA BLVD
Second Line	:	SUITE 100
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-6342
Country	:	US
Telephone Number	:	818-363-8951
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	12/14/2025

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