Provider Demographics
NPI:1992567648
Name:STIEFEL, SOFIE
Entity type:Individual
Prefix:
First Name:SOFIE
Middle Name:
Last Name:STIEFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12436 KLING ST
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1214
Mailing Address - Country:US
Mailing Address - Phone:310-795-0515
Mailing Address - Fax:
Practice Address - Street 1:12436 KLING ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1214
Practice Address - Country:US
Practice Address - Phone:310-795-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst