Healthcare Provider Details

I. General information

NPI: 1518126457
Provider Name (Legal Business Name): STEPHANIE BUELL ROONEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE KAY BUELL

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TAMAL PLZ STE 280
CORTE MADERA CA
94925-1136
US

IV. Provider business mailing address

300 TAMAL PLZ STE 280
CORTE MADERA CA
94925-1136
US

V. Phone/Fax

Practice location:
  • Phone: 415-299-6627
  • Fax:
Mailing address:
  • Phone: 415-299-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY60207930
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY32718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: