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General NPI Number Information
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NPI Number | 1154790749
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Entity Type | Individual
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Provider Name | SANDRA ROCIO STOLFI LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 3841 BRICKWAY BLVD
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City | SANTA ROSA
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State | CA
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Zip | 95403-8226
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Country | US
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Telephone | 707-569-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SHAHAN DR
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City | CLOVERDALE
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State | CA
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Zip | 95425-3017
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Country | US
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Telephone | 707-894-3736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW65492
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | ASW65492
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 84362
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License Number State | CA
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