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NPI Code Detail

MEDICARE: GRACE STEPHENSON AMFT

MEDICARE: GRACE STEPHENSON AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2106H00000XMarriage & Family Therapist159709CA

General Provider Information

NPI Number : 1215761887
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE STEPHENSON AMFT
Provider Business Mailing Address
First Line : 97 VERNON ST APT 8
Second Line :
City : OAKLAND
State : CA
Zip : 94610-4229
Country : US
Telephone Number : 805-312-1289
Fax Number :
Provider Business Practice Location Address
First Line : 7200 BANCROFT AVE STE 267
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2408
Country : US
Telephone Number : 510-735-0864
Fax Number : 510-548-2938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2024
Last Update Date : 12/09/2025

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Directions to “ GRACE STEPHENSON AMFT” Practice Location

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