Basic Information
| Provider Information | |||||||||
| NPI: | 1528453701 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELDSTEIN | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3301 C ST STE 1400 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958163367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167346111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3301 C ST STE 1300 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167346111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2015 | ||||||||
| LastUpdateDate: | 12/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207N00000X | A146480 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.