Provider Demographics
NPI:1811472517
Name:WERNTZ, STEFANI (LMFT)
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:WERNTZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:STEFANI
Other - Middle Name:
Other - Last Name:SOBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2226 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2007
Mailing Address - Country:US
Mailing Address - Phone:408-841-4111
Mailing Address - Fax:408-841-4101
Practice Address - Street 1:2226 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2007
Practice Address - Country:US
Practice Address - Phone:408-841-4111
Practice Address - Fax:408-841-4101
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86021106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty