Healthcare Provider Details

I. General information

NPI: 1962394700
Provider Name (Legal Business Name): JENNIFER MARIE STOEVER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 BEDFORD CANYON RD
CORONA CA
92883-0789
US

IV. Provider business mailing address

3811 BEDFORD CANYON RD
CORONA CA
92883-0789
US

V. Phone/Fax

Practice location:
  • Phone: 951-444-0467
  • Fax: 951-582-4758
Mailing address:
  • Phone: 951-444-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035747
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number557673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: