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NPI Code Detail

MEDICARE: STEPHANIE SOBKA

MEDICARE:   STEPHANIE  SOBKA
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) CounselorCA

General Provider Information

NPI Number : 1932680709
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE SOBKA
Provider Business Mailing Address
First Line : 1315 25TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2107
Country : US
Telephone Number : 196-233-0067
Fax Number :
Provider Business Practice Location Address
First Line : 1315 25TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2107
Country : US
Telephone Number : 196-233-0067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2018
Last Update Date : 08/28/2018

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Directions to “ STEPHANIE SOBKA ” Practice Location

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