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NPI Code Detail

MEDICARE: CIERRA CHERIE STIVERS CADC I

MEDICARE: CIERRA CHERIE STIVERS CADC I
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) CounselorCI34940222CA

General Provider Information

NPI Number : 1528601333
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERRA CHERIE STIVERS CADC I
Provider Business Mailing Address
First Line : 24953 PASEO DE VALENCIA
Second Line : BUILDING B SUITE 1B
City : LAGUNA HILLS
State : CA
Zip : 92653-4340
Country : US
Telephone Number : 949-540-0170
Fax Number : 949-540-0173
Provider Business Practice Location Address
First Line : 24953 PASEO DE VALENCIA
Second Line : BUILDING B SUITE 1B
City : LAGUNA HILLS
State : CA
Zip : 92653-4340
Country : US
Telephone Number : 949-540-0170
Fax Number : 949-540-0173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2019
Last Update Date : 02/21/2022

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1184417388 — CHANDLER SCOTT CORNELL
Practice Location Address:
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Practice Fax: 949-540-0173

Directions to “ CIERRA CHERIE STIVERS CADC I” Practice Location

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