Individual provider Active NPI

Stephanie Michelle Huezo-Lazo

  • Professional Counselor
  • Van Nuys, CA
National Provider Identifier
1912569138
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13767 Issued in CA
Practice address
14624 Sherman Way Ste 508
Van Nuys, CA 91405-2289
Phone
(818) 908-4990
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 7165 CA
Rehabilitation Practitioner 225400000X
Professional Counselor 101YP2500X 13767 CA Primary

Addresses

Primary practice location

14624 Sherman Way Ste 508
Van Nuys, CA 91405-2289

Mailing address

14624 Sherman Way Ste 508
Van Nuys, CA 91405-2289
Phone (818) 908-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13767CAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1912569138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY STE 508",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052289",
            "telephone_number": "818-908-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY STE 508",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052289",
            "telephone_number": "818-908-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEZO-LAZO",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "7165",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "13767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.