Provider Demographics
NPI:1720303423
Name:DURON, STEPHANIE LORRAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LORRAINE
Last Name:DURON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22702 DOBLE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2310
Mailing Address - Country:US
Mailing Address - Phone:310-415-3180
Mailing Address - Fax:
Practice Address - Street 1:261 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2637
Practice Address - Country:US
Practice Address - Phone:562-290-0212
Practice Address - Fax:562-290-0251
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA388271163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0150193OtherMEDI-CAL