Doctor Name: | KRISTEN STEVENSON |
NPI Number: | 1396122321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. |
License Number: | 15686 |
Business Practice Address: | 3031 W March Ln Suite 217 West Stockton, CA - 952196500 |
Business Phone Number: | 2093738393 |
Business Fax Number: | |
Mailing Address: | 3031 W March Ln, Suite 217 West STOCKTON |
State: | CA |
Postal Code: | 952196500 |
Phone Number: | 2093738393 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2015 |
NPI Last Update Date: | 04/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 15686 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |