Basic Information
| Provider Information | |||||||||
| NPI: | 1902324429 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DONABEDIAN | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1827 S ENCINA ST | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932774856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597238881 | ||||||||
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| Practice Location | |||||||||
| Address1: | 327 S K ST | ||||||||
| Address2: | |||||||||
| City: | TULARE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596882043 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2017 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 124941 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.