Provider Demographics
NPI:1407975808
Name:STEPIEN, WALT (MSSW)
Entity Type:Individual
Prefix:
First Name:WALT
Middle Name:
Last Name:STEPIEN
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3638 1/2 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4524
Mailing Address - Country:US
Mailing Address - Phone:619-876-7773
Mailing Address - Fax:
Practice Address - Street 1:3638 1/2 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4524
Practice Address - Country:US
Practice Address - Phone:619-876-7773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical