Provider Demographics
NPI:1558864355
Name:STUMPF, AMIE J (NP)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:J
Last Name:STUMPF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18635 SOLEDAD CANYON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3723
Mailing Address - Country:US
Mailing Address - Phone:661-367-7170
Mailing Address - Fax:
Practice Address - Street 1:18635 SOLEDAD CANYON RD STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-3723
Practice Address - Country:US
Practice Address - Phone:661-367-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily