Healthcare Provider Details

I. General information

NPI: 1336769975
Provider Name (Legal Business Name): SHONNA STEPPE NDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11034 CLOVERHURST WAY
SAN DIEGO CA
92130-2887
US

IV. Provider business mailing address

11034 CLOVERHURST WAY
SAN DIEGO CA
92130-2887
US

V. Phone/Fax

Practice location:
  • Phone: 909-499-4928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: