Basic Information
| Provider Information | |||||||||
| NPI: | 1992731731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLPER | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 BAYWOOD AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944021537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012559279 | ||||||||
| FaxNumber: | 7012559729 | ||||||||
| Practice Location | |||||||||
| Address1: | 1204 ALPINE RD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945964488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106538309 | ||||||||
| FaxNumber: | 9259337145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS15423 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.