Provider Demographics
NPI:1396997839
Name:ANTONIO, DEBORAH HIDEKO (BA, RN)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:HIDEKO
Last Name:ANTONIO
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Gender:F
Credentials:BA, RN
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Mailing Address - Street 1:433 S GRIFFITH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2716
Mailing Address - Country:US
Mailing Address - Phone:818-845-9099
Mailing Address - Fax:
Practice Address - Street 1:2555 E COLORADO BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6622
Practice Address - Country:US
Practice Address - Phone:626-577-2261
Practice Address - Fax:626-577-2543
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAICAN837OtherLA COUNTY DMH