Healthcare Provider Details

I. General information

NPI: 1447162524
Provider Name (Legal Business Name): MR. JOSHUA ROBERT STEVENS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7379 MAGNOLIA AVE APT 17
RIVERSIDE CA
92504-3814
US

IV. Provider business mailing address

7379 MAGNOLIA AVE APT 17
RIVERSIDE CA
92504-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-987-3372
  • Fax:
Mailing address:
  • Phone: 951-987-3372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: