Healthcare Provider Details

I. General information

NPI: 1083534424
Provider Name (Legal Business Name): STEPHANIE COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPH HARRIS

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 AUBURN BLVD STE 100
SACRAMENTO CA
95821-2124
US

IV. Provider business mailing address

2444 SYCAMORE LN APT 1
DAVIS CA
95616-5595
US

V. Phone/Fax

Practice location:
  • Phone: 916-300-6576
  • Fax:
Mailing address:
  • Phone: 510-426-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: