Provider Demographics
NPI:1598217085
Name:STAHL, STEFFANY
Entity Type:Individual
Prefix:
First Name:STEFFANY
Middle Name:
Last Name:STAHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFFANY
Other - Middle Name:
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9139 W STOCKTON BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8059
Mailing Address - Country:US
Mailing Address - Phone:916-684-7844
Mailing Address - Fax:916-684-7168
Practice Address - Street 1:9139 W STOCKTON BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8059
Practice Address - Country:US
Practice Address - Phone:916-684-7844
Practice Address - Fax:916-684-7168
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8002237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist