Provider Demographics
NPI:1124869532
Name:OKAMURA, STEPHANIE MIEKO
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MIEKO
Last Name:OKAMURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-8819
Mailing Address - Country:US
Mailing Address - Phone:559-304-0628
Mailing Address - Fax:
Practice Address - Street 1:305 E CENTER AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6331
Practice Address - Country:US
Practice Address - Phone:559-737-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program