Healthcare Provider Details

I. General information

NPI: 1033055074
Provider Name (Legal Business Name): STEVEN J. STEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16154 ROSE AVE
MONTE SERENO CA
95030-4221
US

IV. Provider business mailing address

16154 ROSE AVE
MONTE SERENO CA
95030-4221
US

V. Phone/Fax

Practice location:
  • Phone: 408-420-2224
  • Fax:
Mailing address:
  • Phone: 408-420-2224
  • Fax: 408-420-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY26264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: