Provider Demographics
NPI:1962410001
Name:IOTT, STEPHANIE (LMFT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:IOTT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 AUBURN BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2134
Mailing Address - Country:US
Mailing Address - Phone:916-677-7722
Mailing Address - Fax:866-462-4494
Practice Address - Street 1:3750 AUBURN BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2134
Practice Address - Country:US
Practice Address - Phone:916-677-7722
Practice Address - Fax:866-462-4494
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39829106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4630OtherLPHA NUMBER FOR THE COUNT