MEDICARE: STEPHON FLETCHER

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1821953340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHON FLETCHER

Provider Business Mailing Address
First Line	:	11604 VANOWEN ST APT 115
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-6195
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11604 VANOWEN ST APT 115
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-6195
Country	:	US
Telephone Number	:	818-290-2771
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ STEPHON FLETCHER ” Practice Location

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