Provider Demographics
NPI:1396418034
Name:DU-WANG, STEPHANIE L (BEHAVIORAL ANALYST)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:DU-WANG
Suffix:
Gender:F
Credentials:BEHAVIORAL ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 BUSH ST STE 3039
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3503
Mailing Address - Country:US
Mailing Address - Phone:888-362-3970
Mailing Address - Fax:
Practice Address - Street 1:5330 COLLEGE AVE STE 240
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-2814
Practice Address - Country:US
Practice Address - Phone:888-362-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-15-19944OtherBCBA