DR. STEPHANIE KOURTAKIS (NPI# 1760021083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760021083 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE KOURTAKIS |
| Credential | PHARMD, BCACP |
| Practice Address |
26520 Cactus Ave Moreno Valley CA 92555-3927 |
| Mailing Address |
535 Watson Dr Claremont CA 91711-4817 |
| Practice Telephone | 9514864000 |
| Mailing Telephone | 2482758317 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
RPH80480 | CA | Pharmacy Service Providers |
| Street Address |
26520 CACTUS AVE |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92555-3927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546414 | Menard Barruga | Pediatrics | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2005-08-24 |
| 1942816392 | Sheron Mathew | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-21 |
| 1669086237 | Brittany Noel Speer | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-01 |
| 1548873110 | Garrett Bao Kha Tran Long | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1639782063 | Yinxi Wu | Social Worker | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1124636246 | Marie Therese Fonseca | Counselor | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-15 |
| 1396363545 | Jackson Helms | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-13 |
| 1588282024 | Adam Kreutzer | Orthopaedic Surgery | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1861010316 | Nicholas Bast | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1699392449 | Xiao Song | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817935 | Jillian Mika Ogata | Social Worker | Riverside University Health System, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2020-10-05 |
| 1114549144 | Providence Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 11165 Bonnie View Ave, Moreno Valley, CA 92555 | 2020-05-13 |
| 1720645096 | Shahida Nawaz | Non-emergency Medical Transport (VAN) | 26528 Primrose Way, Moreno Valley, CA 92555 | 2019-05-22 |
| 1679139828 | Moses Lee | Student in an Organized Health Care Education/Training Program | Department of Orthopaedic Surgery Rm. B2042 Ruhs-mc, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2019-05-14 |
| 1215419668 | Johannes Wattimena | Counselor | 26624 Saffron Circle, Moreno Valley, CA 92555 | 2018-09-02 |
| 1437676939 | Aleksandra Vargas | Behavioral Analyst | 12549 Atherton Dr, Moreno Valley, CA 92555 | 2017-08-25 |
| 1063938603 | Anthony I Odimegwu | Nurse Practitioner | 26062 Bercaw Ct, Moreno Valley, CA 92555 | 2017-08-16 |
| 1073036703 | Karen Parker | Licensed Psychiatric Technician | 12944 Dolomite Lane, Moreno Valley, CA 92555 | 2017-07-25 |
| 1861923674 | Elena Vizcaino | Behavior Technician | 15670 Turnberry St, Moreno Valley, CA 92555 | 2017-03-23 |
| 1154744522 | Nancy Chivichon | Dietitian, Registered | 28648 Avenue Ave., Moreno Valley, CA 92555 | 2014-01-21 |
| Find all providers in zip 92555 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619580909 | Maureen Elizabeth Shelley | Pharmacist | 1212 Pico St Rm 141, San Fernando, CA 91340-3503 | 2020-08-26 |
| 1295351419 | Alice Khalil | Pharmacist | 7555 Van Nuys Blvd # 1071, Van Nuys, CA 91405-1949 | 2020-06-23 |
| 1235752304 | Hang-thu Thi Nguyen | Pharmacist | 4131 Geary Blvd Ste B10, San Francisco, CA 94118-3101 | 2020-05-24 |
| 1861013609 | Karine Wong | Pharmacist | 8264 Noelle Dr, Huntington Beach, CA 92646-6928 | 2020-05-04 |
| 1023656683 | Kenny Tavoc | Pharmacist | 275 N El Cielo Rd Ste C325, Palm Springs, CA 92262-6972 | 2019-12-13 |
| 1124665294 | Paula Kyonghwa Kang | Pharmacist | 23444 Coyote Springs Dr, Diamond Bar, CA 91765-2652 | 2019-12-06 |
| 1194373985 | Louis Ho | Pharmacist | 1225 Wilshire Blvd Ste 201, Los Angeles, CA 90017-1901 | 2019-08-27 |
| 1669026076 | Alan Nguyen | Pharmacist | 1190 Veterans, Cypress Building, Medical Station E, Redwood City, CA 94603-9460 | 2019-07-25 |
| 1174175871 | Patrick Febre | Pharmacist | 3651 Business Dr Ste 100, Sacramento, CA 95820-2176 | 2019-07-12 |
| 1659835866 | Patti Chung | Pharmacist | 200 Medical Plaza Ste 426, Los Angeles, CA 90095-0001 | 2019-01-23 |
| Find all providers with the same taxonomy | ||||
| City | MORENO VALLEY |
| Zip Code | 92555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.