Basic Information
| Provider Information | |||||||||
| NPI: | 1508470287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STUBBLEFIELD | ||||||||
| FirstName: | ABRIANNA | ||||||||
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| Credential: | AMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 E.DATE PALM PASEO | ||||||||
| Address2: | #3199 | ||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9092925227 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14181 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906042554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622730722 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2020 | ||||||||
| LastUpdateDate: | 09/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 105263 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.