Provider Demographics
NPI:1558377572
Name:CONLOW, STEPHANIE S (PT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:S
Last Name:CONLOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16405 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-3044
Mailing Address - Country:US
Mailing Address - Phone:714-823-4400
Mailing Address - Fax:714-823-4404
Practice Address - Street 1:12572 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2006
Practice Address - Country:US
Practice Address - Phone:714-823-4400
Practice Address - Fax:714-823-4404
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2Z0451OtherHEALTH NET
AZAZ0460540OtherBLUECROSS/BLUE SHIELD
AZ846743Medicaid
AZ6058Medicare UPIN
AZ2Z0451OtherHEALTH NET