Doctor Name: | MS. STEFANIE PLATT |
NPI Number: | 1326371501 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PSY 25962 |
Business Practice Address: | 4004 Beyer Blvd San Ysidro, CA - 921732007 |
Business Phone Number: | 6196624100 |
Business Fax Number: | |
Mailing Address: | 1275 30th St, SAN DIEGO |
State: | CA |
Postal Code: | 921543476 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/06/2009 |
NPI Last Update Date: | 08/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY 25962 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |