Deborah Rachell Bryant, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS26623 Issued in CA

Practice address

18880 Cherry Valley Blvd
Tuolumne, CA 95379-9506

Phone

(209) 928-5400

Fax

(209) 928-5412

NPI assigned

Sep 7, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1194006916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3322",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953703322",
            "telephone_number": "209-533-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18880 CHERRY VALLEY BLVD",
            "city": "TUOLUMNE",
            "state": "CA",
            "postal_code": "953799506",
            "telephone_number": "209-928-5400",
            "fax_number": "209-928-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "DEBORAH",
        "middle_name": "RACHELL",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS26623",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "421925",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "421925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Altheide, PEER SPECIALIST
• Cassandra Blackwell, P.A.
• Robert Dennis Boroff, M.D.
• Cynthia Elaine Cassidy, RN
• Sara Croteau, CADC I
• Ephraim Alejandro Delgadillo Jr., CADC-I
• Marni Jean Dick, BCBA
• Dennis Charles Dryden, DDS

• Clinical Social Worker in Tuolumne, CA
• Providers in Tuolumne, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.