Healthcare Provider Details

I. General information

NPI: 1538525381
Provider Name (Legal Business Name): MARY THERESA STEINHOFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2016
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 E ELDER ST STE 105
FALLBROOK CA
92028-3082
US

IV. Provider business mailing address

28780 SINGLE OAK DR STE 260
TEMECULA CA
92590-5534
US

V. Phone/Fax

Practice location:
  • Phone: 760-728-8344
  • Fax:
Mailing address:
  • Phone: 951-676-4193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: