Healthcare Provider Details

I. General information

NPI: 1891610325
Provider Name (Legal Business Name): STEPHANIE MCGRATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 G ST
RIO LINDA CA
95673-4414
US

IV. Provider business mailing address

621 REAMS RD
NEWCASTLE CA
95658-9418
US

V. Phone/Fax

Practice location:
  • Phone: 916-769-4012
  • Fax:
Mailing address:
  • Phone: 916-769-4012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number220275805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: