Provider Demographics
NPI:1518700400
Name:FIELDS, STEFANAE SHAELYN (MS)
Entity type:Individual
Prefix:
First Name:STEFANAE
Middle Name:SHAELYN
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28926 BURROUGH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:TOLLHOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:93667-9796
Mailing Address - Country:US
Mailing Address - Phone:559-307-7297
Mailing Address - Fax:
Practice Address - Street 1:7575 N CEDAR AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2693
Practice Address - Country:US
Practice Address - Phone:559-321-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program