Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A62833 | CA |
NPI | 1134226558 |
---|---|
Provider Name | Dr. Althea Celia Stresino |
First Address | Burbank, CA 91510-7169 |
Second Address | Canoga Park, CA 91303-2016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H52550 | (02) | CA |