Healthcare Provider Details

I. General information

NPI: 1184214694
Provider Name (Legal Business Name): STEPHANIE BELTRAN-PADILLA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 PLACER ST
REDDING CA
96001-1170
US

IV. Provider business mailing address

1035 PLACER ST
REDDING CA
96001-1170
US

V. Phone/Fax

Practice location:
  • Phone: 530-246-5710
  • Fax:
Mailing address:
  • Phone: 530-246-5710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: