Provider Demographics
NPI:1780745372
Name:HANOCH, DEBORAH JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JEAN
Last Name:HANOCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:40 ANDERSON WAY
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6302
Mailing Address - Country:US
Mailing Address - Phone:650-688-3639
Mailing Address - Fax:650-688-0206
Practice Address - Street 1:650 CLARK WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2300
Practice Address - Country:US
Practice Address - Phone:650-688-3639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17193103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist