Individual
MARIAH STANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 521-1805
Mailing address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 521-1805
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/03/2021
Last updated
04/28/2026
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