Healthcare Provider Details

I. General information

NPI: 1386240745
Provider Name (Legal Business Name): STAIRWAY MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21210 ERWIN ST
WOODLAND HILLS CA
91367-3714
US

IV. Provider business mailing address

5348 TOPANGA CANYON BLVD STE 207
WOODLAND HILLS CA
91364-1739
US

V. Phone/Fax

Practice location:
  • Phone: 949-307-0585
  • Fax: 777-747-8930
Mailing address:
  • Phone: 949-307-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JANETTE FLEMING
Title or Position: OFFICE MANAGER
Credential:
Phone: 949-307-0585