Provider Demographics
NPI:1629103817
Name:HSIEH, STEPHANIE Y (MA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:Y
Last Name:HSIEH
Suffix:
Gender:F
Credentials:MA
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 245
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-0245
Mailing Address - Country:US
Mailing Address - Phone:909-687-8920
Mailing Address - Fax:909-646-5956
Practice Address - Street 1:415 W FOOTHILL BLVD STE 212
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2780
Practice Address - Country:US
Practice Address - Phone:909-687-8920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist