Healthcare Provider Details

I. General information

NPI: 1558864355
Provider Name (Legal Business Name): AMIE J STUMPF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2018
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18635 SOLEDAD CANYON RD STE 101
SANTA CLARITA CA
91351-3723
US

IV. Provider business mailing address

18635 SOLEDAD CANYON RD STE 101
SANTA CLARITA CA
91351-3723
US

V. Phone/Fax

Practice location:
  • Phone: 661-367-7170
  • Fax:
Mailing address:
  • Phone: 661-367-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: