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NPI Code Detail

MEDICARE: STEPHEN LOUIS DEVORE MFT

MEDICARE: STEPHEN LOUIS DEVORE MFT
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
1106H00000XMarriage & Family TherapistMFC35457CA

General Provider Information

NPI Number : 1124155734
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN LOUIS DEVORE MFT
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1000
Country : US
Telephone Number : 661-868-6701
Fax Number : 661-868-6752
Provider Business Practice Location Address
First Line : 2621 OSWELL ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93306-3172
Country : US
Telephone Number : 661-868-6701
Fax Number : 661-868-6752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ STEPHEN LOUIS DEVORE MFT” Practice Location

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