Provider Demographics
NPI:1588959555
Name:STABINSKI, INGRID ALICIA (MPA-C, MPH)
Entity type:Individual
Prefix:MS
First Name:INGRID
Middle Name:ALICIA
Last Name:STABINSKI
Suffix:
Gender:F
Credentials:MPA-C, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:225 EAST SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4249
Mailing Address - Country:US
Mailing Address - Phone:760-291-6700
Mailing Address - Fax:
Practice Address - Street 1:225 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4249
Practice Address - Country:US
Practice Address - Phone:760-291-6700
Practice Address - Fax:760-737-7324
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21645363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical