Individual
MRS. STACY ANN VENCILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4870 BARRANCA PKWY, 350, IRVINE, CA 92604-4709
(949) 451-6060
(949) 451-6070
Mailing address
PO BOX 15243, NEWPORT BEACH, CA 92659-5243
(949) 574-4600
(949) 574-4680
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18107
CA
Other
Enumeration date
02/13/2007
Last updated
02/03/2010
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