Provider Demographics
NPI:1659681757
Name:CEDAS-BARKETT, STEPHANIE (MS, MFT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:CEDAS-BARKETT
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:BARKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MFT
Mailing Address - Street 1:455 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6513
Mailing Address - Country:US
Mailing Address - Phone:916-550-2861
Mailing Address - Fax:
Practice Address - Street 1:455 UNIVERSITY AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6513
Practice Address - Country:US
Practice Address - Phone:916-550-2861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48062106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist