Doctor Name: | JODIE N STELZRIEDE |
NPI Number: | 1053546655 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | B8885676 |
Business Practice Address: | 668 Quinan St Suite 200 Pinole, CA - 945641621 |
Business Phone Number: | 9253817887 |
Business Fax Number: | |
Mailing Address: | 3904 Cloverbrook Ave, OAKLEY |
State: | CA |
Postal Code: | 945614237 |
Phone Number: | 9253917887 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2009 |
NPI Last Update Date: | 05/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TF0000X |
License Number: | B8885676 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Family |
Taxonomy Definition: |