Provider Demographics
NPI:1336906056
Name:STEPANIAN, ELLA
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:STEPANIAN
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 1:3030 HIGHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1320
Mailing Address - Country:US
Mailing Address - Phone:818-669-0611
Mailing Address - Fax:
Practice Address - Street 1:3030 HIGHRIDGE RD
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-1320
Practice Address - Country:US
Practice Address - Phone:818-669-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist