Provider Demographics
NPI:1417012477
Name:UKRAINETZ, STEPHANIE ANN DOREEN (BA)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANN DOREEN
Last Name:UKRAINETZ
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Gender:F
Credentials:BA
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Mailing Address - Street 1:1260 MORENA BLVD
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3850
Mailing Address - Country:US
Mailing Address - Phone:619-398-0355
Mailing Address - Fax:619-398-0355
Practice Address - Street 1:1260 MORENA BLVD
Practice Address - Street 2:SUITE # 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3850
Practice Address - Country:US
Practice Address - Phone:619-398-0355
Practice Address - Fax:619-398-0355
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health