Healthcare Provider Details

I. General information

NPI: 1679193403
Provider Name (Legal Business Name): MARISA JOY STOKIEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 MCBEAN PKWY
VALENCIA CA
91355-2083
US

IV. Provider business mailing address

25302 VIA PALACIO
VALENCIA CA
91355-2636
US

V. Phone/Fax

Practice location:
  • Phone: 661-200-2000
  • Fax:
Mailing address:
  • Phone: 310-989-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number687660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: