Provider Demographics
NPI:1477242972
Name:SAGASTUME, STEPHANIE YXCHELL (ACSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:YXCHELL
Last Name:SAGASTUME
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:YXCHELL
Other - Last Name:GARCIA PARTIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:10077 TERRA LOMA DR APT 67
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3239
Mailing Address - Country:US
Mailing Address - Phone:916-273-2394
Mailing Address - Fax:
Practice Address - Street 1:8912 VOLUNTEER LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3221
Practice Address - Country:US
Practice Address - Phone:916-344-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW114545104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker