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General NPI Number Information
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NPI Number | 1700129723
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Entity Type | Individual
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Provider Name | STEPHANIE FENTER L.AC., DIPL.AC.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1050 MARINA VILLAGE PKWY STE 104
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City | ALAMEDA
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State | CA
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Zip | 94501-1033
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Country | US
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Telephone | 510-603-0915
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Fax |
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Provider Business Mailing Address
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Address Line | 149 N CENTRAL AVE
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City | RIDGELAND
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State | MS
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Zip | 39157-2334
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Country | US
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Telephone |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 00010
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 152722
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 14671
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License Number State |
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