Provider Demographics
NPI:1619949856
Name:STEJSKAL, MICHAEL FRANCIS (MS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:STEJSKAL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27349 JEFFERSON AVE
Mailing Address - Street 2:#112
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5634
Mailing Address - Country:US
Mailing Address - Phone:951-296-5690
Mailing Address - Fax:951-296-5693
Practice Address - Street 1:27349 JEFFERSON AVE
Practice Address - Street 2:#112
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5634
Practice Address - Country:US
Practice Address - Phone:951-296-5690
Practice Address - Fax:951-296-5693
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU968231H00000X
CAHA2188231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4594692OtherAETNA ID#
CAZZZ25969ZMedicare ID - Type UnspecifiedMEDICARE GRP
CAZZZ25970ZMedicare ID - Type UnspecifiedMEMBER ID