Provider Demographics
NPI:1386914992
Name:TOTTON, DEBRA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANE
Last Name:TOTTON
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:PO BOX 922
Mailing Address - Street 2:
Mailing Address - City:CALIMESA
Mailing Address - State:CA
Mailing Address - Zip Code:92320-0911
Mailing Address - Country:US
Mailing Address - Phone:909-289-6800
Mailing Address - Fax:
Practice Address - Street 1:1025 CALIMESA BLVD
Practice Address - Street 2:SUITE 5-A
Practice Address - City:CALIMESA
Practice Address - State:CA
Practice Address - Zip Code:92320-1146
Practice Address - Country:US
Practice Address - Phone:909-289-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 150071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26-1359696OtherEIN