Provider Demographics
NPI:1881964393
Name:BROWN, STEPHEN (RN)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23939 VIA HAMACA
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23939 VIA HAMACA
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2810
Practice Address - Country:US
Practice Address - Phone:661-993-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-01
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA710189163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse