Provider Demographics
NPI:1154593739
Name:PLOWMAN, STEPHANIE KAY (DPT, PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAY
Last Name:PLOWMAN
Suffix:
Gender:F
Credentials:DPT, PA-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 CORPORATE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1152
Mailing Address - Country:US
Mailing Address - Phone:949-364-9112
Mailing Address - Fax:949-364-9016
Practice Address - Street 1:800 CORPORATE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-1152
Practice Address - Country:US
Practice Address - Phone:949-364-9112
Practice Address - Fax:949-364-9016
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51344363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical