Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
STEPHANIE MARTEN-ELLIS
Active
Individual
STEPHANIE MARTEN-ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
33931-TLG
CA
152W00000X
Optometrist
9196T
TX
Other
Enumeration date
06/14/2017
Last updated
12/15/2022
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