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NPI Code Detail

MEDICARE: STEPHANIE PORTILLO

MEDICARE: STEPHANIE PORTILLO
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
1101YA0400XAddiction (Substance Use Disorder) CounselorRT1422991125CA

General Provider Information

NPI Number : 1285598730
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE PORTILLO
Provider Business Mailing Address
First Line : 6022 VARIEL AVE
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3719
Country : US
Telephone Number : 818-996-1051
Fax Number : 818-996-1051
Provider Business Practice Location Address
First Line : 6022 VARIEL AVE
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3719
Country : US
Telephone Number : 818-996-1051
Fax Number : 818-996-1051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ STEPHANIE PORTILLO ” Practice Location

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