Provider Demographics
NPI:1033691787
Name:ZAMUDIO, STEPHANIE FLORES (AMFT 131969)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FLORES
Last Name:ZAMUDIO
Suffix:
Gender:F
Credentials:AMFT 131969
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-9601
Mailing Address - Country:US
Mailing Address - Phone:831-455-9965
Mailing Address - Fax:
Practice Address - Street 1:411 E LAKE AVE
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4424
Practice Address - Country:US
Practice Address - Phone:831-728-6445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA131969106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor