Provider Demographics
NPI:1326230137
Name:ARCENEAUX-STEPHENS, STEPHANIE TRICINDA (LVN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:TRICINDA
Last Name:ARCENEAUX-STEPHENS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 TANGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-4127
Mailing Address - Country:US
Mailing Address - Phone:619-920-0826
Mailing Address - Fax:858-560-1368
Practice Address - Street 1:6507 TANGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-4127
Practice Address - Country:US
Practice Address - Phone:619-920-0826
Practice Address - Fax:858-560-1368
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN190941164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse