MEDICARE: MISS STEPHANIE TOVAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	104100000X	Social Worker	ASW135024	CA
3	225400000X	Rehabilitation Practitioner
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1609524834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS STEPHANIE TOVAR

Provider Business Mailing Address
First Line	:	13750 HUBBARD ST UNIT 28
Second Line	:
City	:	SYLMAR
State	:	CA
Zip	:	91342-7493
Country	:	US
Telephone Number	:	818-799-2609
Fax Number	:

Provider Business Practice Location Address
First Line	:	16360 ROSCOE BLVD STE 2
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-1219
Country	:	US
Telephone Number	:	818-901-4830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2022
Last Update Date	:	12/23/2025

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Directions to “ MISS STEPHANIE TOVAR ” Practice Location

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