Healthcare Provider Details

I. General information

NPI: 1457388696
Provider Name (Legal Business Name): JOHN S STEVENSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 588 M/C 7002
SANTA BARBARA CA
93106-7002
US

IV. Provider business mailing address

BUILDING 588 M/C 7002
SANTA BARBARA CA
93106-7002
US

V. Phone/Fax

Practice location:
  • Phone: 805-893-3378
  • Fax: 805-893-4911
Mailing address:
  • Phone: 805-893-3378
  • Fax: 805-893-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA86501
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0010X
TaxonomySports Medicine (Psychiatry & Neurology) Physician
License NumberA86501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: