Provider Demographics
NPI:1962433987
Name:HEMPHILL, STEFANI (MPT)
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 26TH ST
Mailing Address - Street 2:#320
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4698
Mailing Address - Country:US
Mailing Address - Phone:310-453-6166
Mailing Address - Fax:310-453-6154
Practice Address - Street 1:787 E STATE ST STE 135
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7300
Practice Address - Country:US
Practice Address - Phone:323-253-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26173225100000X
ID7434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist