Provider Demographics
NPI:1518126457
Name:ROONEY, STEPHANIE BUELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BUELL
Last Name:ROONEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:BUELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 WEBSTER STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123
Mailing Address - Country:US
Mailing Address - Phone:415-299-6627
Mailing Address - Fax:
Practice Address - Street 1:2901 WEBSTER STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123
Practice Address - Country:US
Practice Address - Phone:415-299-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60207930103T00000X
CA32718103TC1900X
WAPY60207930103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist