Provider Demographics
NPI:1366560187
Name:STEPONOVICH, ERIN ROSE (MS, MFT)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ROSE
Last Name:STEPONOVICH
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2730
Mailing Address - Country:US
Mailing Address - Phone:562-472-4696
Mailing Address - Fax:
Practice Address - Street 1:21840 NORMANDIE AVE STE 500
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2047
Practice Address - Country:US
Practice Address - Phone:562-472-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 51238106H00000X
CA47842106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist