Provider Demographics
NPI:1376056010
Name:SARDELLA, STEPHEN (LMFT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SARDELLA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 MT DIABLO BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4369
Mailing Address - Country:US
Mailing Address - Phone:925-945-0167
Mailing Address - Fax:925-945-0346
Practice Address - Street 1:2099 MT DIABLO BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4369
Practice Address - Country:US
Practice Address - Phone:925-945-0167
Practice Address - Fax:925-945-0346
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC12361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist