Provider Demographics
NPI:1649981911
Name:GRANDE-STRATHDEE, AUBREY RENEE
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:RENEE
Last Name:GRANDE-STRATHDEE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4262
Mailing Address - Country:US
Mailing Address - Phone:209-640-1560
Mailing Address - Fax:
Practice Address - Street 1:5033 KENNETH AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4262
Practice Address - Country:US
Practice Address - Phone:209-640-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist