Healthcare Provider Details

I. General information

NPI: 1659673366
Provider Name (Legal Business Name): MARK DAVID STONGER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2010
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FRANKLIN BLVD
LEMOORE CA
93246-4700
US

IV. Provider business mailing address

937 FRANKLIN BLVD
LEMOORE CA
93246-4700
US

V. Phone/Fax

Practice location:
  • Phone: 719-640-3049
  • Fax:
Mailing address:
  • Phone: 719-640-3049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0004490
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: