Provider Demographics
NPI:1487719944
Name:SANDERS, STEPHANIE HEADSPETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:HEADSPETH
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21168 REDWOOD RD
Mailing Address - Street 2:100A
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5932
Mailing Address - Country:US
Mailing Address - Phone:925-980-3117
Mailing Address - Fax:
Practice Address - Street 1:21168 REDWOOD RD
Practice Address - Street 2:100A
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5932
Practice Address - Country:US
Practice Address - Phone:925-980-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS147781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical