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NPI Code Detail

MEDICARE: STEPHANIE ANNE GIRVAN M.A.

MEDICARE: STEPHANIE ANNE GIRVAN M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistAU 615CA

General Provider Information

NPI Number : 1083667505
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANNE GIRVAN M.A.
Provider Business Mailing Address
First Line : 16111 PLUMMER ST
Second Line : BUILDING 200, ROOM 2413
City : SEPULVEDA
State : CA
Zip : 91343-2036
Country : US
Telephone Number : 818-891-7711
Fax Number : 818-895-5886
Provider Business Practice Location Address
First Line : 16111 PLUMMER ST
Second Line : BUILDING 200, ROOM 2413
City : SEPULVEDA
State : CA
Zip : 91343-2036
Country : US
Telephone Number : 818-891-7711
Fax Number : 818-895-5886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/08/2007

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