Doctor Name: | STACY HOWARD PRINDLE |
NPI Number: | 1043672785 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R.N. |
License Number: | 536537 |
Business Practice Address: | 14659 Olive View Dr Sylmar, CA - 913421652 |
Business Phone Number: | 8184850868 |
Business Fax Number: | |
Mailing Address: | 14659 Olive View Dr, SYLMAR |
State: | CA |
Postal Code: | 913421652 |
Phone Number: | 8184850868 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2016 |
NPI Last Update Date: | 03/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0809X |
License Number: | 536537 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |