Provider Demographics
NPI:1609523042
Name:STOCKEL, CASEY CHRISTINA (PA)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:CHRISTINA
Last Name:STOCKEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8307 SEENO AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6045
Mailing Address - Country:US
Mailing Address - Phone:916-990-4492
Mailing Address - Fax:
Practice Address - Street 1:1355 YORK ST APT 17
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2235
Practice Address - Country:US
Practice Address - Phone:916-990-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program