Provider Demographics
NPI:1326225814
Name:WEST, STEPHANIE MAE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MAE
Last Name:WEST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MAE
Other - Last Name:BABBIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:348 RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4655
Mailing Address - Country:US
Mailing Address - Phone:978-882-1862
Mailing Address - Fax:
Practice Address - Street 1:1601 EASTMAN AVE UNIT 103
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6441
Practice Address - Country:US
Practice Address - Phone:805-650-6290
Practice Address - Fax:805-650-6912
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist