STACY ANNE PETERSEN (NPI# 1144719527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144719527 |
| Entity Type | Individual |
| Full Name | STACY ANNE PETERSEN |
| Credential | FNP-C |
| Practice Address |
700 W 19th St Costa Mesa CA 92627-3517 |
| Mailing Address |
29 Terrace Cir Laguna Niguel CA 92677-4112 |
| Practice Telephone | 9496454646 |
| Mailing Telephone | 9495145228 |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95007971 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063055150 | Stacy Petersen | Specialist/Technologist, Other | 9811 W Charleston Blvd # 2-641, Las Vegas, NV 89117-7528 | 2019-10-22 |
| Street Address |
700 W 19TH ST |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92627-3517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255432639 | Christina Miranda | Physician Assistant | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2006-09-26 |
| 1891253910 | Sano Community Health Center Inc. | Clinic/Center | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2019-03-07 |
| 1306331988 | Judith Lynn Eilmes | Registered Nurse | 700 W 19th St, Costa Mesa, CA 92627 | 2018-06-26 |
| 1467989269 | Lienio Ferreira De Souza | Nurse Practitioner | 700 W 19th St, Costa Mesa, CA 92627 | 2017-05-11 |
| 1528465762 | Sano Medical Clinic | Clinic/Center | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2014-12-03 |
| 1558799767 | Patricia Merchent | Nurse Practitioner | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2013-10-25 |
| 1871858688 | Family Dental | Preferred Provider Organization | 700 W 19th St, Suite C, Costa Mesa, CA 92627-3517 | 2012-07-09 |
| 1356627558 | Aimee Cabrera Pestano | Nurse Practitioner | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2011-11-01 |
| 1932255221 | Donna Ball | Nurse Practitioner | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2007-01-27 |
| 1093891061 | Tiffany Le | Physician Assistant | 700 W 19th St, Costa Mesa, CA 92627-3517 | 2006-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1245703412 | Allure Transportation | Non-emergency Medical Transport (VAN) | 1835 Newport Blvd Ste 109 #110, Costa Mesa, CA 92627 | 2019-01-09 |
| 1750857686 | Living Success Center | Marriage & Family Therapist | 445 E. 17th Street, Suites D & E, Costa Mesa, CA 92627 | 2018-10-18 |
| 1790298909 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-a University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1679086862 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-b University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1245759018 | Surgical Assistant Associates | Clinic/Center | 186 E. 16th Street, Suite C, Costa Mesa, CA 92627 | 2017-09-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1386189033 | Jian Yi Ye | Acupuncturist | 2488 Newport Blvd Ste B1, Costa Mesa, CA 92627 | 2017-01-04 |
| 1144764606 | Michele Marie Patton | Dental Hygienist | 2220 Fairview Rd., Costa Mesa, CA 92627 | 2016-12-18 |
| 1881148500 | Valerie Nguyen | Pharmacist | 1835 Newport Blvd # C, Costa Mesa, CA 92627 | 2016-08-10 |
| Find all providers in zip 92627 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546872 | Brett Ashley Hartsfield | Nurse Practitioner | 485 E 17th St Ste 500, Costa Mesa, CA 92627-4705 | 2019-09-11 |
| 1558894741 | Lai Man Wong | Nurse Practitioner | 150 Paularino Ave Bld D Suite 182, Costa Mesa, CA 92626 | 2017-04-05 |
| 1720520182 | Andrea Beyaoju | Nurse Practitioner | 771 Allegheny Ave, Costa Mesa, CA 92626-3002 | 2016-11-15 |
| 1518417633 | Arnold Franco | Nurse Practitioner | 3360 Via Trentino, Costa Mesa, CA 92626-1691 | 2016-10-12 |
| 1609324524 | Angela Ciano | Nurse Practitioner | 2306 Elden Ave, Apt C, Costa Mesa, CA 92627-6504 | 2016-09-20 |
| 1972960078 | Sandra Lynn Gordon-bitar | Nurse Practitioner | 2975 Redhill Avenue, Suite 175, Costa Mesa, CA 92626 | 2016-01-20 |
| 1194005975 | Laura Conahan | Nurse Practitioner | 2200 Harbor Blvd Suite B210, Costa Mesa, CA 92627 | 2011-08-24 |
| 1245519172 | Patricia Thalken Lash | Nurse Practitioner | 1190 Baker Street, 100, Costa Mesa, CA 92659 | 2011-08-09 |
| 1831428028 | Claudene Koros Stark | Nurse Practitioner | 1150 Baker Street, Minute Clinic, Costa Mesa, CA 92626 | 2009-12-17 |
| 1629101589 | Nicole Herriott | Nurse Practitioner | 2569 Orange Ave Apt J, Costa Mesa, CA 92627-5119 | 2007-03-13 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92627 |
Please comment or provide details below to improve the information on STACY ANNE PETERSEN.
| 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.