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General NPI Number Information
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NPI Number | 1992534408
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Entity Type | Individual
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Provider Name | STEPHANIE LEAH PIMENTEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/01/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 200 BUTCHER RD
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City | VACAVILLE
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State | CA
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Zip | 95687-5616
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Country | US
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Telephone | 888-660-4243
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Fax | 833-233-2448
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Provider Business Mailing Address
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Address Line | 757 BAYVIEW CT
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City | EL SOBRANTE
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State | CA
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Zip | 94803-1305
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Country | US
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Telephone | 510-701-2930
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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 | LCSW76963
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License Number State | CA
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