MEDICARE: CLAIRE STEVENS LEP

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	101YS0200X	School Counselor	4028	CA

General Provider Information

NPI Number	:	1891569117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE STEVENS LEP

Provider Business Mailing Address
First Line	:	2271 ALPINE BLVD STE A
Second Line	:
City	:	ALPINE
State	:	CA
Zip	:	91901-1101
Country	:	US
Telephone Number	:	888-688-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3835 AVOCADO BLVD STE 270
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-8524
Country	:	US
Telephone Number	:	888-688-0248
Fax Number	:

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

Provider Enumeration Date	:	11/07/2023
Last Update Date	:	11/07/2023

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Directions to “ CLAIRE STEVENS LEP” Practice Location

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