Provider Demographics
NPI:1912202987
Name:MESSINA, STEPHANIE (PA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MESSINA
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:4 PARK PLZ
Mailing Address - Street 2:SUITE 150
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-8560
Mailing Address - Country:US
Mailing Address - Phone:949-430-3963
Mailing Address - Fax:949-430-3964
Practice Address - Street 1:4 PARK PLZ
Practice Address - Street 2:SUITE 150
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-8560
Practice Address - Country:US
Practice Address - Phone:949-430-3963
Practice Address - Fax:949-430-3964
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2021-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA21409363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant