Doctor Name: | DR. LAURIE ANN STEPHENS |
NPI Number: | 1063536407 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY 18520 |
Business Practice Address: | 2235 N Lake Ave Suite 201 Altadena, CA - 910012465 |
Business Phone Number: | 6267971500 |
Business Fax Number: | 6267975317 |
Mailing Address: | 15219 Magnolia Blvd, Unit D SHERMAN OAKS |
State: | CA |
Postal Code: | 914031125 |
Phone Number: | 8189057490 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 09/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY 18520 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |