Provider Demographics
NPI:1013330620
Name:ACEVEDO, STEPHANIE ARIANA (LMFT, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ARIANA
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:LMFT, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4582 RHAPSODY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2273
Mailing Address - Country:US
Mailing Address - Phone:714-743-0704
Mailing Address - Fax:
Practice Address - Street 1:4582 RHAPSODY DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-2273
Practice Address - Country:US
Practice Address - Phone:714-743-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-10236103K00000X, 103K00000X
CA98990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist