Provider Demographics
NPI:1972971430
Name:KITAY, DEBORAH LYNN (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:KITAY
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 1:512 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3065
Mailing Address - Country:US
Mailing Address - Phone:310-400-6723
Mailing Address - Fax:
Practice Address - Street 1:512 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3065
Practice Address - Country:US
Practice Address - Phone:310-400-6723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CA105063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist