Provider Demographics
NPI:1205517752
Name:HAVENS-STOKES, ELISA RENEE
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:RENEE
Last Name:HAVENS-STOKES
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 1:901 CASTLEWOOD DR APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1330
Mailing Address - Country:US
Mailing Address - Phone:831-236-6417
Mailing Address - Fax:
Practice Address - Street 1:901 CASTLEWOOD DR APT 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1330
Practice Address - Country:US
Practice Address - Phone:831-236-6417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula