Provider Demographics
NPI:1295449148
Name:STEFFENS, GINA MARIE (ACSW)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:STEFFENS
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:STEFFENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW
Mailing Address - Street 1:8193 KEATS AVE
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-6117
Mailing Address - Country:US
Mailing Address - Phone:760-660-3042
Mailing Address - Fax:
Practice Address - Street 1:58383 29 PALMS HWY STE 101
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5891
Practice Address - Country:US
Practice Address - Phone:760-365-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1118691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical