Provider Demographics
NPI:1275922478
Name:STOVER, STEVEN (MS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:STOVER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-2390
Mailing Address - Country:US
Mailing Address - Phone:619-672-4850
Mailing Address - Fax:
Practice Address - Street 1:4283 EL CAJON BLVD
Practice Address - Street 2:RM 115
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1289
Practice Address - Country:US
Practice Address - Phone:619-521-1743
Practice Address - Fax:619-521-1896
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health