Provider Demographics
NPI:1609569227
Name:BACHELLER, STEPHANIE R (LMFT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:BACHELLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-0125
Mailing Address - Country:US
Mailing Address - Phone:831-655-5505
Mailing Address - Fax:
Practice Address - Street 1:442 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2827
Practice Address - Country:US
Practice Address - Phone:831-655-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78381106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist