Provider Demographics
NPI:1033268248
Name:STEFFEN, CLARISSA ELLEN (EDD)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:ELLEN
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 LINCOLN WAY
Mailing Address - Street 2:#36
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:530-888-9250
Mailing Address - Fax:530-888-9259
Practice Address - Street 1:884 LINCOLN WAY
Practice Address - Street 2:#36
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-888-9250
Practice Address - Fax:530-888-9259
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18594103T00000X
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist