Individual
DEBORAH WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11927 ELLIOTT AVE, EL MONTE, CA 91732-3740
(626) 350-0805
Mailing address
1977 N GAREY AVE, STE 6, POMONA, CA 91767-2774
(909) 623-6651
(909) 623-0455
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001588
LACDMH STAFF CODE
CA
Enumeration date
09/30/2008
Last updated
09/30/2008
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