Healthcare Provider Details

I. General information

NPI: 1043755267
Provider Name (Legal Business Name): STEPHANY AUYON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2016
Last Update Date: 12/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2536 ROCKWOOD AVE STE 107
CALEXICO CA
92231-4408
US

IV. Provider business mailing address

PO BOX 8001
CALEXICO CA
92232-8001
US

V. Phone/Fax

Practice location:
  • Phone: 760-768-3422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: