Healthcare Provider Details

I. General information

NPI: 1750645743
Provider Name (Legal Business Name): STEFANI LAFRENIERRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SUPERIOR AVE STE 210
NEWPORT BEACH CA
92663-3640
US

IV. Provider business mailing address

1501 SUPERIOR AVE STE 210
NEWPORT BEACH CA
92663-3640
US

V. Phone/Fax

Practice location:
  • Phone: 949-996-5355
  • Fax:
Mailing address:
  • Phone: 949-996-5355
  • Fax: 949-996-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA127530
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR8227
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA127530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: