Individual
STEPHANIE DEROUICHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E MARKET ST, LONG BEACH, CA 90805-5910
(310) 795-1233
Mailing address
2074 BALTIC AVE, LONG BEACH, CA 90810-4058
(310) 795-1233
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6832
CA
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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