Provider Demographics
NPI:1528329257
Name:NAZEMI, STEPHANIE ALYECE (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ALYECE
Last Name:NAZEMI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74000 COUNTRY CLUB DR STE A5
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-1677
Mailing Address - Country:US
Mailing Address - Phone:760-773-3400
Mailing Address - Fax:760-771-3200
Practice Address - Street 1:74000 COUNTRY CLUB DR STE A5
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-1677
Practice Address - Country:US
Practice Address - Phone:760-773-3400
Practice Address - Fax:760-771-3200
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor