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General NPI Number Information
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NPI Number | 1831783059
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Entity Type | Individual
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Provider Name | STACEY BERNSEN STANFIELD NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/28/2021
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Last Update Date | 02/28/2021
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90036-4663
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Country | US
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Telephone | 323-375-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 188 N CRESCENT DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5403
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Country | US
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Telephone | 901-603-3511
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95016731
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License Number State | CA
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