Provider Demographics
NPI:1558492173
Name:DOYLE, STEPHEN EDWARD (RN )
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:DOYLE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 MOUNTAIN TOP DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4848
Mailing Address - Country:US
Mailing Address - Phone:909-862-7129
Mailing Address - Fax:909-387-7008
Practice Address - Street 1:820 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0002
Practice Address - Country:US
Practice Address - Phone:909-387-7200
Practice Address - Fax:909-387-7008
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363282163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health