Provider Demographics
NPI:1184137507
Name:FLETCHER, STEPHANIE WERTZ (MA, LMFT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:WERTZ
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1228
Mailing Address - Country:US
Mailing Address - Phone:415-519-1124
Mailing Address - Fax:
Practice Address - Street 1:4224 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1394
Practice Address - Country:US
Practice Address - Phone:415-870-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist