Individual
MRS. JOANNA SCHAFHAUSEN STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1721 21ST ST, SANTA MONICA, CA 90404-3916
(310) 829-7391
Mailing address
1721 21ST ST, SANTA MONICA, CA 90404-3916
(310) 829-7391
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060802156
BOARD OF CERTIFICATION
CA
Enumeration date
04/12/2016
Last updated
05/09/2017
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