Provider Demographics
NPI:1831895598
Name:ARNOLD STERN, MERRISA
Entity type:Individual
Prefix:
First Name:MERRISA
Middle Name:
Last Name:ARNOLD STERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERRISA
Other - Middle Name:
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1258 VALIANT ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5444
Mailing Address - Country:US
Mailing Address - Phone:661-903-3026
Mailing Address - Fax:
Practice Address - Street 1:1258 VALIANT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5444
Practice Address - Country:US
Practice Address - Phone:661-903-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE1098818OtherDRIVERS LISCENSE