Provider Demographics
NPI:1962712836
Name:ROYER, DELTON RAY (LCSW)
Entity type:Individual
Prefix:
First Name:DELTON
Middle Name:RAY
Last Name:ROYER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:DEL
Other - Middle Name:
Other - Last Name:ROYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW66260
Mailing Address - Street 1:2101 COURAGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6717
Mailing Address - Country:US
Mailing Address - Phone:707-428-1131
Mailing Address - Fax:
Practice Address - Street 1:2101 COURAGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-428-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical