Provider Demographics
NPI:1538447115
Name:STIFEL, SKYE WHITE FRASER (MED, PHD)
Entity type:Individual
Prefix:DR
First Name:SKYE
Middle Name:WHITE FRASER
Last Name:STIFEL
Suffix:
Gender:F
Credentials:MED, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5595 FLOYD ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-9097
Mailing Address - Country:US
Mailing Address - Phone:310-433-4446
Mailing Address - Fax:
Practice Address - Street 1:1200 PASEO CAMARILLO STE 245
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6085
Practice Address - Country:US
Practice Address - Phone:805-988-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
CA3629103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool