Healthcare Provider Details

I. General information

NPI: 1912811282
Provider Name (Legal Business Name): MILLIE IVANOV STOYTCHEV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25336 DOVE LN
STEVENSON RANCH CA
91381-1668
US

IV. Provider business mailing address

25336 DOVE LN
STEVENSON RANCH CA
91381-1668
US

V. Phone/Fax

Practice location:
  • Phone: 818-517-6613
  • Fax:
Mailing address:
  • Phone: 818-517-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95041709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: