Healthcare Provider Details

I. General information

NPI: 1992617211
Provider Name (Legal Business Name): MS. STEPHANIE ALLEN BAGLIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-4055
  • Fax:
Mailing address:
  • Phone: 818-847-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95333809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: