Healthcare Provider Details

I. General information

NPI: 1508774167
Provider Name (Legal Business Name): STEPHANI ROSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7761 COLONIAL WAY
CENTRAL POINT OR
97502-9704
US

IV. Provider business mailing address

7761 COLONIAL WAY
CENTRAL POINT OR
97502-9704
US

V. Phone/Fax

Practice location:
  • Phone: 209-743-4975
  • Fax:
Mailing address:
  • Phone: 209-743-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: