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General NPI Number Information
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NPI Number | 1013220581
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Entity Type | Individual
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Provider Name | STELLA MORDEN PHD, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 1500 21ST ST
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City | SACRAMENTO
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State | CA
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Zip | 95811-5216
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Country | US
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Telephone | 916-914-6358
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 ROSALIND AVE
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City | RICHMOND
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State | CA
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Zip | 94805-1551
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Country | US
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Telephone | 412-401-6047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP010853
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22665
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License Number State | CA
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