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1104590025
STEPHANIE TANYA RANDALL
SAN DIEGO, CA
NPI
1104590025
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Former Name
STEPHANIE TANYA FISCHER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95017990)
Enumeration Date
2021-08-04
Last Update Date
2024-06-03
Business Address
Mrs. STEPHANIE TANYA RANDALL NP
5160 FEDERAL BLVD
SAN DIEGO, CA 92105
Phone number: 619-515-2300
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Mailing Address
Mrs. STEPHANIE TANYA RANDALL NP
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102-4541
Phone number: 619-515-2300
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