MEDICARE: STEPHANIE HA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1356861520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HA

Provider Business Mailing Address
First Line	:	5420 KOHLER RD UNIT 417405
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-6061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 KOHLER RD UNIT 417405
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-6061
Country	:	US
Telephone Number	:	415-745-1321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	04/12/2026

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Directions to “ STEPHANIE HA ” Practice Location

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