Provider Demographics
NPI:1154346922
Name:SMITH-WOTRING, DEBORAH L (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:SMITH-WOTRING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 CASS ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4550
Mailing Address - Country:US
Mailing Address - Phone:831-238-7323
Mailing Address - Fax:831-622-9802
Practice Address - Street 1:2100 GARDEN RD
Practice Address - Street 2:BLDNG B, SUITE 6-D
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-238-7323
Practice Address - Fax:831-622-9802
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS200841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5540436Medicaid