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General NPI Number Information
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NPI Number | 1316654098
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Entity Type | Individual
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Provider Name | STEPHANIE THOMAS APRN
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Gender | Female
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 25431 CABOT RD STE 118
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5527
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Country | US
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Telephone | 863-670-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 25431 CABOT RD STE 118
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5527
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Country | US
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Telephone | 863-670-4062
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95022310
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License Number State | CA
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