Healthcare Provider Details

I. General information

NPI: 1033373733
Provider Name (Legal Business Name): WAYNE EUGENE STEMMLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3608 STEVE MCQUEEN DR
CHINO HILLS CA
91709-5455
US

IV. Provider business mailing address

1907 BOYS REPUBLIC DR
CHINO HILLS CA
91709-5447
US

V. Phone/Fax

Practice location:
  • Phone: 909-740-3138
  • Fax:
Mailing address:
  • Phone: 909-628-1217
  • Fax: 909-306-5427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number99467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: