Provider Demographics
NPI:1568658037
Name:STEVENS, SUELLEN E (MD)
Entity type:Individual
Prefix:DR
First Name:SUELLEN
Middle Name:E
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6320 MISTFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-6604
Mailing Address - Country:US
Mailing Address - Phone:502-551-5703
Mailing Address - Fax:310-943-2188
Practice Address - Street 1:6200 WILSHIRE BLVD STE 1410
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5815
Practice Address - Country:US
Practice Address - Phone:323-403-0474
Practice Address - Fax:310-943-2188
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2025-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA1609082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry