Provider Demographics
NPI:1497967418
Name:STEPHENSON, DENISE MARIE (NP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARIE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:CATHCART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, NP
Mailing Address - Street 1:2722 CURRIER AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5162
Mailing Address - Country:US
Mailing Address - Phone:805-378-1413
Mailing Address - Fax:
Practice Address - Street 1:7075 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1605
Practice Address - Country:US
Practice Address - Phone:805-378-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429733363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner