Provider Demographics
NPI:1306386164
Name:STUBBS, MILEDREA ANN (MFTT)
Entity Type:Individual
Prefix:MS
First Name:MILEDREA
Middle Name:ANN
Last Name:STUBBS
Suffix:
Gender:F
Credentials:MFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 PHEASANT CIR
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6807
Mailing Address - Country:US
Mailing Address - Phone:925-864-0261
Mailing Address - Fax:
Practice Address - Street 1:2702 CLAYTON RD
Practice Address - Street 2:STE. 200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2789
Practice Address - Country:US
Practice Address - Phone:925-798-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist