Provider Demographics
NPI:1740559095
Name:GRINSTEAD, STEPHEN F (MFT)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:GRINSTEAD
Suffix:
Gender:M
Credentials:MFT
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 340626
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-0626
Mailing Address - Country:US
Mailing Address - Phone:916-575-9961
Mailing Address - Fax:916-575-9961
Practice Address - Street 1:4200 N FREEWAY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1235
Practice Address - Country:US
Practice Address - Phone:916-575-9961
Practice Address - Fax:916-575-9961
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37823106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist