Stephanie Deatherage

NPI 1669090346 · on the registry since 2020 · sole proprietor

Practice

Address: 3505 Cadillac Avenue
Building O, Suite 110
Costa Mesa, CA 92626
Phone: (949) 290-0114
Organisation at this address: Ready To Ride
Pathways To Wellness
Apexcare Pharma Solutions Corporation
California Treatment Collective, Llc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2025-04-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California