MEDICARE: STEFANIE A PROIA CPNP

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
1	363LP0200X	Pediatric Nurse Practitioner	NP18431	CA

General Provider Information

NPI Number	:	1700035193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE A PROIA CPNP

Provider Business Mailing Address
First Line	:	18546 ROSCOE BLVD
Second Line	:	SUITE 211
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-4663
Country	:	US
Telephone Number	:	818-885-8040
Fax Number	:	818-267-5633

Provider Business Practice Location Address
First Line	:	18546 ROSCOE BLVD
Second Line	:	SUITE 211
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-4663
Country	:	US
Telephone Number	:	818-885-8040
Fax Number	:	818-267-5633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	05/22/2026

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