Healthcare Provider Details

I. General information

NPI: 1679482913
Provider Name (Legal Business Name): STEPHANIE DAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 OCEAN VIEW BLVD STE B
GLENDALE CA
91208-3306
US

IV. Provider business mailing address

2700 E CHAUCER ST UNIT 27
LOS ANGELES CA
90065-1852
US

V. Phone/Fax

Practice location:
  • Phone: 818-945-9731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: