Provider Demographics
NPI:1376132845
Name:CATOUR, STEFANI MARIE
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:MARIE
Last Name:CATOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W MOUNTAIN VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85045-0505
Mailing Address - Country:US
Mailing Address - Phone:480-234-9947
Mailing Address - Fax:
Practice Address - Street 1:1260 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3054
Practice Address - Country:US
Practice Address - Phone:480-234-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program