Provider Demographics
NPI:1932117512
Name:DOWDEN, STEPHANIE JOY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOY
Last Name:DOWDEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:JOY
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2315 STOCKTON BLVD
Mailing Address - Street 2:UC DAVIS MEDICAL CENTER S2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-7839
Mailing Address - Fax:916-734-8929
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:UC DAVIS MEDICAL CENTER
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-7839
Practice Address - Fax:916-734-8929
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP15800363L00000X
CA15800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P28857Medicare UPIN
CACJ038ZMedicare PIN