Provider Demographics
NPI:1174256903
Name:STEPHAN, CYNTHIA (MS, AMFT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:STEPHAN
Suffix:
Gender:F
Credentials:MS, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 B STREET
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:707-536-5069
Mailing Address - Fax:
Practice Address - Street 1:576 B STREET
Practice Address - Street 2:SUITE 2C
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401
Practice Address - Country:US
Practice Address - Phone:707-536-5069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist