Healthcare Provider Details

I. General information

NPI: 1154760270
Provider Name (Legal Business Name): MS. STEPHANIE SKEWES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7707 S AUSTIN ROAD DEPARTMENT OF STATE HOSPITALS-STOCKTON
STOCKTON CA
95215
US

IV. Provider business mailing address

7707 S AUSTIN ROAD DEPARTMENT OF STATE HOSPITALS-STOCKTON
STOCKTON CA
95215
US

V. Phone/Fax

Practice location:
  • Phone: 916-654-2351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: