Provider Demographics
NPI:1508980921
Name:TRUDEAU, STEPHEN DONALD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DONALD
Last Name:TRUDEAU
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30941 AGOURA RD
Mailing Address - Street 2:SUITE 228
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4617
Mailing Address - Country:US
Mailing Address - Phone:805-794-7270
Mailing Address - Fax:
Practice Address - Street 1:30941 AGOURA RD
Practice Address - Street 2:SUITE 228
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4617
Practice Address - Country:US
Practice Address - Phone:805-794-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical