Provider Demographics
NPI:1972879252
Name:SINGH, STEFANIE JEAN (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:JEAN
Last Name:SINGH
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:DR
Other - First Name:STEFANIE
Other - Middle Name:JEAN
Other - Last Name:STEPANSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, LAC
Mailing Address - Street 1:27022 PACIFIC TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5001
Mailing Address - Country:US
Mailing Address - Phone:323-351-7949
Mailing Address - Fax:
Practice Address - Street 1:4100 BIRCH ST STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2275
Practice Address - Country:US
Practice Address - Phone:949-417-0420
Practice Address - Fax:877-631-2676
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31923111N00000X
CAAC14684171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor