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General NPI Number Information
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NPI Number | 1770993636
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL DESTEFANO II DAOM, L.AC., CMT
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Gender | Male
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 17451 BASTANCHURY RD STE 101B
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City | YORBA LINDA
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State | CA
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Zip | 92886-1870
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Country | US
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Telephone | 714-694-7194
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Fax |
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Provider Business Mailing Address
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Address Line | 18340 YORBA LINDA BLVD STE 107-405
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City | YORBA LINDA
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State | CA
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Zip | 92886-4058
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Country | US
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Telephone | 858-336-9139
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Fax | 310-307-2989
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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 | 16965
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License Number State | CA
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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 | DA00454
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | CMT 12010
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License Number State | CA
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