Provider Demographics
NPI:1992964092
Name:GLORIA, DEBORAH LOUISE (CADC II COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LOUISE
Last Name:GLORIA
Suffix:
Gender:F
Credentials:CADC II COUNSELOR
Other - Prefix:
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Mailing Address - Street 1:413 MORALES CT
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-6802
Mailing Address - Country:US
Mailing Address - Phone:707-301-9777
Mailing Address - Fax:707-446-2179
Practice Address - Street 1:800 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2411
Practice Address - Country:US
Practice Address - Phone:707-651-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA8351802101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)