1457584526 NPI number — BOBI MARIE STONE

Table of content: KLAER TAWADROUS LPC, CRC (NPI 1902654031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457584526 NPI number — BOBI MARIE STONE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STONE
Provider First Name:
BOBI
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYS
Provider Other First Name:
ROBERTA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457584526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25424 HARDY PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STEVENSON RANCH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91381-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-606-6103
Provider Business Mailing Address Fax Number:
661-678-0711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23542 LYONS AVE STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWHALL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91321-5713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-606-6103
Provider Business Practice Location Address Fax Number:
661-678-0711
Provider Enumeration Date:
08/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  84066 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)