Basic Information
| Provider Information | |||||||||
| NPI: | 1912363631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAGER | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 253 N CENTER ST | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928661503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494312311 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5712 CAMP ST | ||||||||
| Address2: | |||||||||
| City: | CYPRESS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906303145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148282000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2016 | ||||||||
| LastUpdateDate: | 01/11/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMF85822 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.