Provider Demographics
NPI:1982036265
Name:STEGMAN, RACHEL L (MFTI)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:STEGMAN
Suffix:
Gender:F
Credentials:MFTI
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 1066
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-7066
Mailing Address - Country:US
Mailing Address - Phone:925-565-7535
Mailing Address - Fax:
Practice Address - Street 1:201 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2124
Practice Address - Country:US
Practice Address - Phone:925-565-7535
Practice Address - Fax:925-332-0371
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104802103TC1900X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty