Provider Demographics
NPI:1699059253
Name:KLIPPER, DEBRA JOY (MSNNP)
Entity type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:JOY
Last Name:KLIPPER
Suffix:
Gender:F
Credentials:MSNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 DEAUVILLE PLACE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-473-0280
Mailing Address - Fax:
Practice Address - Street 1:601 W 19TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5060
Practice Address - Country:US
Practice Address - Phone:714-922-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA543710363LA2200X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health