Healthcare Provider Details

I. General information

NPI: 1922972140
Provider Name (Legal Business Name): SLOANE STEPHENS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S ACACIA AVE
COMPTON CA
90220-3702
US

IV. Provider business mailing address

4538 CAMELLIA AVE
STUDIO CITY CA
91602-1908
US

V. Phone/Fax

Practice location:
  • Phone: 559-250-6393
  • Fax:
Mailing address:
  • Phone: 559-250-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: SYBIL SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential: ED.D
Phone: 559-250-6393