What is Jerry Stupar's NPI number?

The NPI number assigned to this healthcare provider is 1770641607, enumerated as a individual on December 4, 2006.

Where is the provider located?

The provider is located at 10605 BALBOA BLVD STE 100 GRANADA HILLS, CA 91344 and the phone number is (818) 366-0325.

What is the provider's specialty?

The provider's specialty is Registered Nurse with taxonomy code 163WP0809X and a focus in Psychiatric/Mental Health, Adult.

MR. JERRY JOSEPH STUPAR REGISTERED NURSE - NPI 1770641607 - Registered Nurse in Granada Hills, CA

On this page

About Mr. Jerry Joseph Stupar Registered Nurse NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY JOSEPH STUPAR REGISTERED NURSE (NPI 1770641607) is an individual psychiatric/mental health, adult provider in Granada Hills, California, licensed in California (613194) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1770641607

Entity TypeIndividualMale

Primary Taxonomy163WP0809X

Provider Legal NameMR. JERRY JOSEPH STUPARCredential: REGISTERED NURSE

Location Address10605 BALBOA BLVD STE 100Granada Hills, CA 91344-6367

Mailing Address10605 Balboa Blvd Ste 100Granada Hills, CA 91344-6367 · (818) 366-0325 · Fax (818) 363-8951

Phone(818) 366-0325

Fax(818) 363-8951

Sole ProprietorNo

Enumeration DateDecember 4, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1770641607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental Health, AdultNursing Service Providers

Taxonomy Code163WP0809X

License✔ Licensed in CA · 613194

10605 BALBOA BLVD STE 100, Granada Hills, CA 91344

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARINA MARTIN LCSW

Social Worker (Clinical)