Provider Demographics
NPI:1275175127
Name:STEPHENS, ANAVAH (DOULA, CHILDBIRTH ED)
Entity Type:Individual
Prefix:
First Name:ANAVAH
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:DOULA, CHILDBIRTH ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:571-442-3966
Mailing Address - Fax:
Practice Address - Street 1:53 SOUTHERN HILLS DR
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656
Practice Address - Country:US
Practice Address - Phone:571-442-3966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program