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Individual

STEFANIYA TABANLIEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-7326
(800) 926-8273

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11029241
FL
363LA2100X
Acute Care Nurse Practitioner
11029241
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
95027914
CA

Other

Enumeration date
03/28/2024
Last updated
12/08/2025
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