Provider Demographics
NPI:1831471804
Name:BEHROUZMAND-STRATTON, MADDI ALEXANDRA-HAMILTON (ASW)
Entity type:Individual
Prefix:
First Name:MADDI
Middle Name:ALEXANDRA-HAMILTON
Last Name:BEHROUZMAND-STRATTON
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:HAMILTON
Other - Last Name:STRATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4340 GOLDEN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6254
Mailing Address - Country:US
Mailing Address - Phone:530-621-7700
Mailing Address - Fax:
Practice Address - Street 1:4340 GOLDEN CENTER DR
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6254
Practice Address - Country:US
Practice Address - Phone:530-621-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health