Bloesch, Stephanie Ann

Bloesch, Stephanie Ann is an individual health care provider with primary practice located at 171 Carlos Dr , San Rafael CA 94903-2005. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Bloesch, Stephanie Ann can be contacted via phone (415) 755-2310.

Contact Information

Primary practice address
171 Carlos Dr San Rafael CA 94903-2005
Phone: (415) 755-2310
Fax: (415) 755-2210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MFC41505 California
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X MFC 41505 California

Profile Details

NPI number 1932267366
LBN Legal business name Bloesch, Stephanie Ann
Credentials Marriage and Family Therapist (MFT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Jun 3rd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932267366 NPPES
California Other 2109 MEDI-CAL

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