Healthcare Provider Details

I. General information

NPI: 1861396947
Provider Name (Legal Business Name): STEPHANIE MARIE DABOUB ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 HEALTH SCIENCES RD STE 2600
IRVINE CA
92617-3058
US

IV. Provider business mailing address

33 WILLOW TREE LN UNIT 2
IRVINE CA
92612-2247
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: