Provider Demographics
NPI:1972929842
Name:PASCAL, STEPHANIE ELVIRA (OTR)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ELVIRA
Last Name:PASCAL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3501 MALL VIEW RD
Mailing Address - Street 2:SUITE 115-274
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3058
Mailing Address - Country:US
Mailing Address - Phone:661-319-9713
Mailing Address - Fax:661-873-0206
Practice Address - Street 1:3845 STOCKDALE HWY
Practice Address - Street 2:SUITE 17
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3192
Practice Address - Country:US
Practice Address - Phone:661-364-7800
Practice Address - Fax:661-364-7800
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)