Provider Demographics
NPI:1457893810
Name:YOUNAN, STEPHANIE KATTOULA (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KATTOULA
Last Name:YOUNAN
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:RITA
Other - Last Name:KATTOULA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1748 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-3605
Mailing Address - Country:US
Mailing Address - Phone:619-490-9735
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-4539
Practice Address - Country:US
Practice Address - Phone:619-532-8595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist