Provider Demographics
NPI:1225636152
Name:PAAPE, STEPHANIE J (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:PAAPE
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 VAN NUYS BLVD STE 516
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1832
Mailing Address - Country:US
Mailing Address - Phone:818-789-6296
Mailing Address - Fax:
Practice Address - Street 1:4955 VAN NUYS BLVD STE 516
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1832
Practice Address - Country:US
Practice Address - Phone:818-789-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58686207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty