MEDICARE: STEFANIE MARY SCHLOSSER

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	363LF0000X	Family Nurse Practitioner	95018972	CA

General Provider Information

NPI Number	:	1780349787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE MARY SCHLOSSER

Provider Business Mailing Address
First Line	:	12442 LIMONITE AVE UNIT 205
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-2467
Country	:	US
Telephone Number	:	909-429-2864
Fax Number	:

Provider Business Practice Location Address
First Line	:	12442 LIMONITE AVE
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-2467
Country	:	US
Telephone Number	:	909-429-2864
Fax Number	:

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

Provider Enumeration Date	:	11/04/2021
Last Update Date	:	04/17/2024

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