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General NPI Number Information
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NPI Number | 1902440605
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Entity Type | Individual
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Provider Name | STEPHEN ROBERT LE MASTERS
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Gender | Male
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 510 W MAIN ST STE 104
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City | EL CENTRO
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State | CA
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Zip | 92243-2900
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Country | US
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Telephone | 760-353-6922
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Fax | 760-353-8441
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Provider Business Mailing Address
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Address Line | PO BOX 2219
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City | EL CENTRO
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State | CA
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Zip | 92244-2219
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Country | US
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Telephone | 760-353-6922
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Fax | 760-353-8441
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 70261
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License Number State | CA
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