Healthcare Provider Details

I. General information

NPI: 1841051240
Provider Name (Legal Business Name): STACIE TURKS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180&2ND
PASADENA CA
91101-6143
US

IV. Provider business mailing address

401 HILLSIDE AVE
MORRISVILLE PA
19067-6233
US

V. Phone/Fax

Practice location:
  • Phone: 646-453-6777
  • Fax: 212-337-9841
Mailing address:
  • Phone: 805-512-0421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: