TIMOTHY JAMES STACY (NPI# 1457356479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457356479 |
| Entity Type | Individual |
| Full Name | TIMOTHY JAMES STACY |
| Credential | ACNP |
| Practice Address |
4955 Van Nuys Blvd Suite 502 Sherman Oaks CA 91403-1801 |
| Mailing Address |
5268 Huckleberry Oak Street Simi Valley CA 93063 |
| Practice Telephone | 8183250200 |
| Practice Fax Number | 8183250210 |
| Mailing Telephone | 8052080434 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2010-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
15005 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 2571636 | 05 | |
| CA | MEDICARE PTAN | B1180Z | 01 |
| CA | NP0150050 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710540422 | Timothy Kyle Stacy | Counselor | 46 E Water St, Chillicothe, OH 45601-2544 | 2019-04-18 |
| Street Address |
4955 VAN NUYS BLVD SUITE 502 |
| City | SHERMAN OAKS |
| State | CA |
| Zip Code | 91403-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265915367 | Jennifer Floyd | Physical Therapy Assistant | 4955 Van Nuys Blvd, Sherman Oaks, CA 91403-1801 | 2018-09-13 |
| 1801335609 | Sohail Parham A Prof Dental Corp | Dentist | 4955 Van Nuys Blvd, Ste 520, Sherman Oaks, CA 91403-1801 | 2017-02-14 |
| 1104368364 | Barbara Hibbits | Marriage & Family Therapist | 4955 Van Nuys Blvd, Suite 200, Sherman Oaks, CA 91403-1801 | 2016-11-04 |
| 1790237113 | Healing Compounds Inc | Pharmacy | 4955 Van Nuys Blvd, Sherman Oaks, CA 91403-1801 | 2016-11-02 |
| 1467903716 | Addison Asc LLC | Clinic/Center | 4955 Van Nuys Blvd, Suite 719, Sherman Oaks, CA 91403-1801 | 2016-10-21 |
| 1942664834 | Think and Be Treatment Center | Counselor | 4955 Van Nuys Blvd, Ste. 210, Sherman Oaks, CA 91403-1801 | 2016-04-07 |
| 1265893242 | Irina Binder | Pharmacist | 4955 Van Nuys Blvd, Sherman Oaks, CA 91403-1801 | 2016-03-17 |
| 1568827145 | Harold Perlaza Dds A Professional Dental Corporation | Dentist | 4955 Van Nuys Blvd, #202, Sherman Oaks, CA 91403-1801 | 2015-12-23 |
| 1902273576 | Vidya Vijay Nair | Nurse Practitioner | 4955 Van Nuys Blvd, Suite 502, Sherman Oaks, CA 91403-1801 | 2015-08-30 |
| 1225431992 | Dominique Sisto | Physician Assistant | 4955 Van Nuys Blvd, Suite 615, Sherman Oaks, CA 91403-1801 | 2014-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1245844596 | Montage Recovery California | Psychiatric Residential Treatment Facility | 15367 Valley Vista Blvd, Sherman Oaks, CA 91403 | 2020-09-03 |
| 1053870741 | Quality Life Experience | Assistant Behavior Analyst | 4723 1/4 Vista Del Monte, Sherman Oaks, CA 91403 | 2019-03-13 |
| 1871092254 | Andrew Pascual | Hospitalist | 4929 Van Nuys Blvs, Sherman Oaks, CA 91403 | 2018-02-12 |
| 1063941466 | Nancy Green Satenberg | Counselor | 4419 Van Nuys Blvd Ste. 301, Sherman Oaks, CA 91403 | 2017-06-08 |
| 1710414875 | Jeffery Edward Havig | Registered Nurse | 1536 Mission St, San Francisco, CA 91403 | 2017-05-18 |
| 1700310885 | Judy Koutal | Behavioral Analyst | 15720 Sutton St, Apt 201, Sherman Oaks, CA 91403 | 2017-04-17 |
| 1043742133 | Christa Maria Eskelin | Marriage & Family Therapist | 4419 Van Nuys Blvd, Suite 400, Sherman Oaks, CA 91403 | 2017-03-29 |
| 1760841431 | Dent All By Dr. Z | Dentist | 15301 Ventura Blvd. Ste U-5, Sherman Oaks, CA 91403 | 2016-02-23 |
| 1821456286 | Liana Kogan | Speech-Language Pathologist | 14569 Benefit Street, #312, Sherman Oaks, CA 91403 | 2016-02-01 |
| Find all providers in zip 91403 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815808 | Lia Christian | Nurse Practitioner | 14605 Burbank Blvd Apt 109, Sherman Oaks, CA 91411-4308 | 2020-09-08 |
| 1255982492 | Travis Petrick | Nurse Practitioner | 15353 Weddington St Apt C107, Sherman Oaks, CA 91411-3844 | 2019-09-27 |
| 1275005621 | Valentina Obreja | Nurse Practitioner | 14960 Dickens St Unit 212, Sherman Oaks, CA 91403-3466 | 2018-12-26 |
| 1174002992 | Nareene Safarian | Nurse Practitioner | 14572 Dickens St Unit 303, Sherman Oaks, CA 91403-3777 | 2018-08-13 |
| 1295221125 | Alexandria Rudolph | Nurse Practitioner | 14724 Ventura Blvd Ste 420, Sherman Oaks, CA 91403-3501 | 2018-07-03 |
| 1083157606 | Christopher Gerard Negrete | Nurse Practitioner | 4911 Van Nuys Blvd Ste 102, Sherman Oaks, CA 91403-6802 | 2016-11-30 |
| 1790168953 | Svetlana Radchenko | Nurse Practitioner | 4915 Tyrone Ave Apt 214, Sherman Oaks, CA 91423-1107 | 2015-07-07 |
| 1528668571 | Maria Teresa Sanchez | Nurse Practitioner | 5805 Sepulveda Blvd Ste 690, Sherman Oaks, CA 91411-2522 | 2020-10-29 |
| 1134753445 | Ronald Phillip Bataclan | Nurse Practitioner | 4929 Van Nuys Blvd, Sherman Oaks, CA 91403-1702 | 2020-02-25 |
| 1750930707 | Monica Abigail Arellano Keh | Nurse Practitioner | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2019-09-11 |
| Find all providers in SHERMAN OAKS | ||||
| City | SHERMAN OAKS |
| Zip Code | 91403 |
Please comment or provide details below to improve the information on TIMOTHY JAMES STACY.
| 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.