Individual
DEANNA M DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
355 TUOLUMNE ST, VALLEJO, CA 94590-5700
(707) 553-5102
Mailing address
355 TUOLUMNE ST # MS 20-100, VALLEJO, CA 94590-5700
(510) 673-7617
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
98841
CA
101YM0800X
Mental Health Counselor
98841
CA
104100000X
Social Worker
Primary
98841
CA
1041C0700X
Clinical Social Worker
199673
CA
Other
Enumeration date
03/29/2021
Last updated
07/25/2023
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