Provider Demographics
NPI:1699381517
Name:STEPHENS, PAIGE LAUREN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:LAUREN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W COAST HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5000
Mailing Address - Country:US
Mailing Address - Phone:949-272-3325
Mailing Address - Fax:949-333-2962
Practice Address - Street 1:6961 LOS AMIGOS CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6659
Practice Address - Country:US
Practice Address - Phone:714-841-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299031225100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation