Provider Demographics
NPI:1033682687
Name:SANDERS, STEPHANIE FRANCES (MA, AMFT, APCC,RADT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FRANCES
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MA, AMFT, APCC,RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27352 BAVELLA WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-1586
Mailing Address - Country:US
Mailing Address - Phone:619-549-8361
Mailing Address - Fax:
Practice Address - Street 1:130 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2632
Practice Address - Country:US
Practice Address - Phone:831-771-8537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114932106H00000X
CA6716101YP2500X
CAR1337610219101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA114932OtherASSOCIATE MARRIAGE AND FAMILY THERAPIST
CAAPCC6716OtherASSOCIATE PROFESSIONAL CLINICAL COUNSELOR