Provider Demographics
NPI:1457388696
Name:STEVENSON, JOHN S (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:STEVENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:BUILDING 588 M/C 7002
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-7002
Mailing Address - Country:US
Mailing Address - Phone:805-893-3378
Mailing Address - Fax:805-893-4911
Practice Address - Street 1:BUILDING 588 M/C 7002
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7002
Practice Address - Country:US
Practice Address - Phone:805-893-3378
Practice Address - Fax:805-893-4911
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86501207Q00000X, 2084S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3951196OtherAETNA
1435770OtherCIGNA HEALTH PLAN
92687OtherFALLON COMM HEALTH PLAN
470391OtherTUFTS HEALTH PLAN
AA37555OtherHARVARD PILGRAM HLTH CARE
2104211OtherMEDICAID WELFARE
56300014OtherFIRST HEALTH
MA2104211Medicaid
3951196OtherUS HEALTHCARE
J29087QOtherBLUE CARE ELECT
384187OtherMVP HEALTH CARE
38797OtherCHILDRENS MED SEC PLAN
0103069OtherEVERCARE
38797OtherHEALTHY START
92687OtherFALLON COMM HEALTH PLAN
3951196OtherAETNA
3951196OtherUS HEALTHCARE