Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95009236 | CA |
NPI | 1003398538 |
---|---|
Provider Name | Sarah Stephens |
First Address | Orange, CA 92868-3849 |
Second Address | Orange, CA 92868-3849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2018 |
Last Update Date | 31/08/2018 |