Provider Demographics
NPI:1467576280
Name:STOUFFLET, RITA A (MSPAS, MPH, PA-C)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:STOUFFLET
Suffix:
Gender:F
Credentials:MSPAS, MPH, PA-C
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Other - Last Name:
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE STE 180
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0303
Practice Address - Country:US
Practice Address - Phone:916-536-2408
Practice Address - Fax:916-536-2465
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAT31122255A2300X
CA53693363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer