Healthcare Provider Details

I. General information

NPI: 1518185958
Provider Name (Legal Business Name): STEPHANIE A HUFFMAN SP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25150 HANCOCK AVE SUITE 100
MURRIETA CA
92562
US

IV. Provider business mailing address

24630 WASHINGTON AVE STE 200
MURRIETA CA
92562-6177
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-7720
  • Fax: 951-698-7451
Mailing address:
  • Phone: 951-696-9353
  • Fax: 951-973-7216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP13441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: