Provider Demographics
NPI:1386771236
Name:HERTZLER-WALTERS, DEBORAH (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HERTZLER-WALTERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BETHANY DR STE H
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-2821
Mailing Address - Country:US
Mailing Address - Phone:831-454-0117
Mailing Address - Fax:831-454-0117
Practice Address - Street 1:125 BETHANY DR STE H
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-2821
Practice Address - Country:US
Practice Address - Phone:831-454-0117
Practice Address - Fax:831-454-0117
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 21487106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist