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General NPI Number Information
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NPI Number | 1215409057
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Entity Type | Organization
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Legal Business Name | STEPHANIE L. SANDERS, LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 6480 WEATHERS PL STE 102
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City | SAN DIEGO
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State | CA
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Zip | 92121-3911
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Country | US
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Telephone | 858-956-5545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 759
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City | POWAY
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State | CA
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Zip | 92074-0759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE L SANDERS
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Credential | LCSW
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Telephone | 619-363-5228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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