Provider Demographics
NPI:1649478603
Name:STAHLER, WESLEY JENNIFER (MFTI)
Entity type:Individual
Prefix:MS
First Name:WESLEY
Middle Name:JENNIFER
Last Name:STAHLER
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-3551
Mailing Address - Country:US
Mailing Address - Phone:510-428-8417
Mailing Address - Fax:
Practice Address - Street 1:638 3RD ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3551
Practice Address - Country:US
Practice Address - Phone:510-428-8417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44307174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist