Provider Demographics
NPI:1952642944
Name:STANFORD, JEANNE (PHD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:STANFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COUNSELING & PSYCHOLOGICAL SERVICES
Mailing Address - Street 2:UC SANTA BARBARA
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-7030
Mailing Address - Country:US
Mailing Address - Phone:805-893-4411
Mailing Address - Fax:805-893-5259
Practice Address - Street 1:COUNSELING & PSYCHOLOGICAL SERVICES
Practice Address - Street 2:UC SANTA BARBARA
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7030
Practice Address - Country:US
Practice Address - Phone:805-893-4411
Practice Address - Fax:805-893-5259
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12763103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist