=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457584526
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BOBI MARIE STONE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2009
-----------------------------------------------------
Last Update Date | 03/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23542 LYONS AVE STE 202
-----------------------------------------------------
City | NEWHALL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91321-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-606-6103
-----------------------------------------------------
Fax | 661-678-0711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25424 HARDY PL
-----------------------------------------------------
City | STEVENSON RANCH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91381-1504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-606-6103
-----------------------------------------------------
Fax | 661-678-0711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 84066
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------