Provider Demographics
NPI:1508470287
Name:STUBBLEFIELD, ABRIANNA (AMFT)
Entity Type:Individual
Prefix:
First Name:ABRIANNA
Middle Name:
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 E.DATE PALM PASEO
Mailing Address - Street 2:#3199
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764
Mailing Address - Country:US
Mailing Address - Phone:909-292-5227
Mailing Address - Fax:
Practice Address - Street 1:14181 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2554
Practice Address - Country:US
Practice Address - Phone:562-273-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105263101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health