Provider Demographics
NPI:1013167022
Name:DUFFY, STACY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 WESTLAKE CTR # 156
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1430
Mailing Address - Country:US
Mailing Address - Phone:650-485-3812
Mailing Address - Fax:
Practice Address - Street 1:555 MIDDLEFIELD RD # 210
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2124
Practice Address - Country:US
Practice Address - Phone:650-485-3812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY26067103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health