Provider Demographics
NPI:1477658979
Name:STOLZOFF, MARSHA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:A
Last Name:STOLZOFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26932 OSO PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-582-8895
Mailing Address - Fax:949-348-9626
Practice Address - Street 1:26932 OSO PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-582-8895
Practice Address - Fax:949-348-9626
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12768103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY127680Medicaid
CP12768Medicare ID - Type Unspecified