Provider Demographics
NPI:1487286332
Name:STEPANSKI, PAIGE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:STEPANSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:ABERLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4508 3RD ST APT 34
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5564
Mailing Address - Country:US
Mailing Address - Phone:989-255-6214
Mailing Address - Fax:
Practice Address - Street 1:4508 3RD ST APT 34
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5564
Practice Address - Country:US
Practice Address - Phone:989-255-6214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT20632225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist