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General NPI Number Information
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NPI Number | 1730323866
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Entity Type | Individual
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Provider Name | MS. CHINA KEYONNIE GASSOWAY STEVENSON
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Gender | Female
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 4010 WATSON PLAZA DR SUITE 135
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City | LAKEWOOD
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State | CA
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Zip | 90712-4037
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Country | US
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Telephone | 562-421-7225
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Fax | 562-421-7221
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Provider Business Mailing Address
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Address Line | 3605 LONG BEACH BLVD SUITE 331
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City | LONG BEACH
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State | CA
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Zip | 90807-4013
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Country | US
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Telephone | 562-989-0515
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Fax | 562-421-7221
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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