Provider Demographics
NPI:1508470287
Name:STUBBLEFIELD, ABRIANNA (AMFT)
Entity type:Individual
Prefix:
First Name:ABRIANNA
Middle Name:
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 E.DATE PALM PASEO
Mailing Address - Street 2:#3199
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764
Mailing Address - Country:US
Mailing Address - Phone:909-292-5227
Mailing Address - Fax:
Practice Address - Street 1:1325 E COOLEY DR STE 106
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3966
Practice Address - Country:US
Practice Address - Phone:909-782-5588
Practice Address - Fax:909-752-6182
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist