Provider Demographics
NPI:1932301348
Name:STAHLHOFEN, ELAINE HELEN (MS)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:HELEN
Last Name:STAHLHOFEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HELENE
Other - Middle Name:
Other - Last Name:REDWOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92088-0129
Mailing Address - Country:US
Mailing Address - Phone:760-822-9033
Mailing Address - Fax:
Practice Address - Street 1:27720 JEFFERSON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2610
Practice Address - Country:US
Practice Address - Phone:951-506-0864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist