Provider Demographics
NPI:1568520666
Name:PEOPLES, STEPHANIE ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31946 MISSION TRAIL
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4539
Mailing Address - Country:US
Mailing Address - Phone:951-245-7663
Mailing Address - Fax:951-674-6431
Practice Address - Street 1:31946 MISSION TRAIL
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530
Practice Address - Country:US
Practice Address - Phone:951-245-7663
Practice Address - Fax:951-674-6431
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist