Healthcare Provider Details

I. General information

NPI: 1609524834
Provider Name (Legal Business Name): MISS STEPHANIE TOVAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16360 ROSCOE BLVD STE 2
VAN NUYS CA
91406-1219
US

IV. Provider business mailing address

13750 HUBBARD ST UNIT 28
SYLMAR CA
91342-7493
US

V. Phone/Fax

Practice location:
  • Phone: 818-901-4830
  • Fax:
Mailing address:
  • Phone: 818-799-2609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW135024
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: