Healthcare Provider Details

I. General information

NPI: 1982388310
Provider Name (Legal Business Name): MEG K STOMSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BISSO LN STE 200
CONCORD CA
94520-4886
US

IV. Provider business mailing address

1704 FRANCISCO ST APT E
BERKELEY CA
94703-1338
US

V. Phone/Fax

Practice location:
  • Phone: 888-678-7277
  • Fax:
Mailing address:
  • Phone: 914-391-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: