Provider Demographics
NPI:1043349889
Name:ROMAIN-STAVE, PAULETTE MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:MARIE
Last Name:ROMAIN-STAVE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:PAULETTE
Other - Middle Name:MARIE
Other - Last Name:ROMAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:21520 PIONEER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21520 PIONEER BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2603
Practice Address - Country:US
Practice Address - Phone:562-865-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical