Provider Demographics
NPI:1932611373
Name:CASCIO, STEPHANIE JEANNE (FNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JEANNE
Last Name:CASCIO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45268 MIRO CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1370
Mailing Address - Country:US
Mailing Address - Phone:310-490-9221
Mailing Address - Fax:
Practice Address - Street 1:4537 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4010
Practice Address - Country:US
Practice Address - Phone:800-970-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily