Basic Information
| Provider Information | |||||||||
| NPI: | 1649403726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEINRICH | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | DELAO | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WEINRICH | ||||||||
| OtherFirstName: | DEBRA | ||||||||
| OtherMiddleName: | DELAO | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MSW, LCSW | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10 DECLARATION DR | ||||||||
| Address2: | STE B | ||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959734931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304330936 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10 DECLARATION DR | ||||||||
| Address2: | STE B | ||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959734931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912784 | ||||||||
| FaxNumber: | 5308912908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2009 | ||||||||
| LastUpdateDate: | 02/02/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS # 25625 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.