Agoncillo, Stephanie

Agoncillo, Stephanie is an individual health care provider with primary practice located at 2911 Chanticleer Ave , Santa Cruz CA 95065-1815. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Agoncillo, Stephanie can be contacted via phone (831) 477-2350.

Contact Information

Primary practice address
2911 Chanticleer Ave Santa Cruz CA 95065-1815
Phone: (831) 477-2350
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 53464 California

Profile Details

NPI number 1427425172
LBN Legal business name Agoncillo, Stephanie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2015
Last updated Nov 19th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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