Provider Demographics
NPI:1427860931
Name:STEPHAN MARRIAGE AND FAMILY THERAPY INC.
Entity type:Organization
Organization Name:STEPHAN MARRIAGE AND FAMILY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KERIANNE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:STEPHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-351-6783
Mailing Address - Street 1:1208 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2406
Mailing Address - Country:US
Mailing Address - Phone:949-351-6783
Mailing Address - Fax:
Practice Address - Street 1:110 GOUGH ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5945
Practice Address - Country:US
Practice Address - Phone:650-744-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty