Provider Demographics
NPI:1568627628
Name:CONFALONE, STEPHANIE MARIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:CONFALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 DIAMOND ST
Mailing Address - Street 2:UNIT # 119
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3319
Mailing Address - Country:US
Mailing Address - Phone:914-879-6304
Mailing Address - Fax:
Practice Address - Street 1:1775 DIAMOND ST
Practice Address - Street 2:UNIT # 119
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3319
Practice Address - Country:US
Practice Address - Phone:914-879-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health