Bedolla, Stephanie Lisette

Bedolla, Stephanie Lisette is an individual health care provider with primary practice located at 16977 Healdsburg Ave , Healdsburg CA 95448-3261. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bedolla, Stephanie Lisette can be contacted via phone (510) 929-1400.

Contact Information

Primary practice address
16977 Healdsburg Ave Healdsburg CA 95448-3261
Phone: (510) 929-1400
Fax: (510) 929-1414
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN2275566 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X NPP37728 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 95002835 California

Profile Details

NPI number 1265717565
LBN Legal business name Bedolla, Stephanie Lisette
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2011
Last updated Nov 29th, 2023 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1265717565 NPPES
Massachusetts MEDICAID 11009205/A
Massachusetts MEDICAID SB90061

Popular Providers