Provider Demographics
NPI:1255653705
Name:STOLDEN, SHEILA
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:STOLDEN
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 1:129 SINCLAIR AVE
Mailing Address - Street 2:#3
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-6262
Mailing Address - Country:US
Mailing Address - Phone:909-855-7374
Mailing Address - Fax:
Practice Address - Street 1:13800 HEACOCK ST
Practice Address - Street 2:SUITE #C236
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3339
Practice Address - Country:US
Practice Address - Phone:951-653-0819
Practice Address - Fax:951-656-2614
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health