Provider Demographics
NPI:1467649574
Name:STOVALL, STEPHANIE (BA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:STOVALL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 OAK GROVE RD STE 11
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3253
Mailing Address - Country:US
Mailing Address - Phone:925-646-5436
Mailing Address - Fax:925-646-5102
Practice Address - Street 1:1026 OAK GROVE RD STE 11
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3253
Practice Address - Country:US
Practice Address - Phone:925-646-5436
Practice Address - Fax:925-646-5102
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health