Healthcare Provider Details

I. General information

NPI: 1275822975
Provider Name (Legal Business Name): MEGHAN ELIZABETH STEVENS OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

IV. Provider business mailing address

18980 PACHAPPA RD
APPLE VALLEY CA
92307-1531
US

V. Phone/Fax

Practice location:
  • Phone: 760-552-6700
  • Fax:
Mailing address:
  • Phone: 810-516-1514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: