Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stephanie Marie Deatherage

Individual provider Clinical Social Worker · NPI 1669090346

Mrs. Stephanie Marie Deatherage is a Clinical Social Worker in Costa Mesa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

3505 Cadillac Ave Bldg O Ste 110
Costa Mesa, CA 92626-1429
Phone: (949) 290-0114
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW129363 (CA)

Record details

NPI number1669090346
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 9, 2020
Last updated in NPPESApril 8, 2025
Certification dateApril 8, 2025

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