Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY 28471 | CA |
Y | 103T00000X | Psychologist | PSY 28471 | CA |
NPI | 1013464239 |
---|---|
Provider Name | Dr. Stephanie Van Stralen |
First Address | Newport Beach, CA 92660-2194 |
Second Address | Los Angeles, CA 90095-1556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2016 |
Last Update Date | 13/04/2020 |