Provider Demographics
NPI:1528476934
Name:SPANIAK, STEPHANIE (AMFT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SPANIAK
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:KHRIMYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:7001A EAST PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-639-0719
Mailing Address - Fax:916-854-8824
Practice Address - Street 1:7001A EAST PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2501
Practice Address - Country:US
Practice Address - Phone:916-639-0719
Practice Address - Fax:916-854-8824
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAAMFT149587106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator