Healthcare Provider Details

I. General information

NPI: 1861916736
Provider Name (Legal Business Name): STEPHANIE LEE POCWIERZ RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY # B032
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

7601 IMPERIAL HWY JPI B032
DOWNEY CA
90242-3456
US

V. Phone/Fax

Practice location:
  • Phone: 562-385-7584
  • Fax:
Mailing address:
  • Phone: 562-385-7584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number38258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: