Healthcare Provider Details

I. General information

NPI: 1518365410
Provider Name (Legal Business Name): STEPHANIE ANNE GRANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41261A ROAD 40
REEDLEY CA
93654-9140
US

IV. Provider business mailing address

41261A ROAD 40
REEDLEY CA
93654-9140
US

V. Phone/Fax

Practice location:
  • Phone: 559-393-1056
  • Fax:
Mailing address:
  • Phone: 559-393-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020564
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 25120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: