Provider Demographics
NPI:1225097355
Name:CALCAGNO, STEPHANIE ANN (MA, MFT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:CALCAGNO
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2317
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-2317
Mailing Address - Country:US
Mailing Address - Phone:760-438-1324
Mailing Address - Fax:760-438-1324
Practice Address - Street 1:800 GRAND AVE
Practice Address - Street 2:C-12A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1808
Practice Address - Country:US
Practice Address - Phone:760-599-5496
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist