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General NPI Number Information
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NPI Number | 1700569878
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Entity Type | Individual
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Provider Name | JULIE STEFAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 334 EAGLE DR
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City | PLACENTIA
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State | CA
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Zip | 92870-4441
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Country | US
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Telephone | 657-246-3079
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 222
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City | PLACENTIA
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State | CA
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Zip | 92871-0222
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Country | US
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Telephone | 657-246-3079
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 25103
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License Number State | CA
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