Individual
AMANDA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 271-1140
(530) 271-7036
Mailing address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 333-9460
(530) 333-1019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
60280
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1346780519
CA
Other
Enumeration date
06/28/2017
Last updated
07/31/2019
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