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General NPI Number Information
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NPI Number | 1578891370
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Entity Type | Organization
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Legal Business Name | STEPPING STONES PEDIATRIC THERAPY
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 3301 TARECO DRIVE
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City | LOS ANGELES
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State | CA
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Zip | 90068
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Country | US
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Telephone | 323-883-1830
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 TARECO DRIVE
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City | LOS ANGELES
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State | CA
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Zip | 90068
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Country | US
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Telephone | 323-883-1830
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Fax |
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Authorized Official
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Title or Position | OWNER, PT
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Name | SHELBY FORN
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Credential | PT
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Telephone | 323-333-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT 27055
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License Number State | CA
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