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General NPI Number Information
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NPI Number | 1326905654
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Entity Type | Individual
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Provider Name | ALICIA M STUFOSO OT
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Gender | Female
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 115 W ALLEN AVE
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City | SAN DIMAS
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State | CA
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Zip | 91773-1437
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Country | US
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Telephone | 909-971-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 LESTER CIR
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City | WAXHAW
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State | NC
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Zip | 28173-0329
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Country | US
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Telephone | 626-833-9004
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 4223
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License Number State | CA
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