Healthcare Provider Details

I. General information

NPI: 1245528769
Provider Name (Legal Business Name): STEPHANIE PAQUIN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARBOR BLVD
BELMONT CA
94002-4018
US

IV. Provider business mailing address

300 HARBOR BLVD
BELMONT CA
94002-4018
US

V. Phone/Fax

Practice location:
  • Phone: 650-817-9070
  • Fax: 650-817-9074
Mailing address:
  • Phone: 650-817-9070
  • Fax: 650-817-9074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT87375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: