Individual
ETHAN STIFFELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
17555 VENTURA BLVD, ENCINO, CA 91316-3890
(818) 305-1952
Mailing address
17555 VENTURA BLVD, ENCINO, CA 91316-3890
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
Primary
25-QMHS-I-00137
CA
Other
Enumeration date
04/30/2025
Last updated
08/13/2025
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