Provider Demographics
NPI:1992948954
Name:WOLFSON, STEPHEN SAFFORD (MA, LMFT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:SAFFORD
Last Name:WOLFSON
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:777 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:SUITE 200-180
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6784
Mailing Address - Country:US
Mailing Address - Phone:310-584-1146
Mailing Address - Fax:310-584-1146
Practice Address - Street 1:23852 PACIFIC COAST HWY # 268
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4879
Practice Address - Country:US
Practice Address - Phone:310-584-1146
Practice Address - Fax:310-584-1146
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist