Provider Demographics
NPI:1073711214
Name:NEWMAN, STEPHANNIE RAQUEL
Entity Type:Individual
Prefix:MS
First Name:STEPHANNIE
Middle Name:RAQUEL
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 BRIARTREE WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-1008
Mailing Address - Country:US
Mailing Address - Phone:916-308-1141
Mailing Address - Fax:
Practice Address - Street 1:3077 FITE CIR
Practice Address - Street 2:SUITE 6
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1814
Practice Address - Country:US
Practice Address - Phone:916-854-1801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health