Provider Demographics
NPI:1679967947
Name:REDING, STEPHEN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:REDING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12755 N HIGHWAY 88
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-9323
Mailing Address - Country:US
Mailing Address - Phone:707-340-5802
Mailing Address - Fax:
Practice Address - Street 1:341 IRWIN LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5603
Practice Address - Country:US
Practice Address - Phone:707-360-1500
Practice Address - Fax:707-360-1958
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health