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General NPI Number Information
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NPI Number | 1679967947
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Entity Type | Individual
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Provider Name | STEPHEN REDING
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Gender | Male
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 341 IRWIN LN
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City | SANTA ROSA
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State | CA
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Zip | 95401-5603
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Country | US
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Telephone | 707-360-1500
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Fax | 707-360-1958
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Provider Business Mailing Address
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Address Line | 12755 N HIGHWAY 88
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City | LODI
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State | CA
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Zip | 95240-9323
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Country | US
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Telephone | 707-340-5802
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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