| Doctor Name: | MR. CLARENCE KRESGE STILES |
| NPI Number: | 1407952732 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SOCIAL WORKER |
| License Number: | 7076 |
| Business Practice Address: | 11301 Wilshire Blvd Bldg 206 La, CA - 90093 |
| Business Phone Number: | 3104783711 |
| Business Fax Number: | 3102684050 |
| Mailing Address: | 1787 S. Tiara St., ANAHEIM |
| State: | CA |
| Postal Code: | 92802 |
| Phone Number: | 3104783711 |
| Fax Number: | 3102684050 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 7076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |