STACEY PHELPS (NPI# 1528396868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528396868 |
| Entity Type | Individual |
| Full Name | STACEY PHELPS |
| Credential | PA-C |
| Practice Address |
2500 Milvia St Ste 218 Berkeley CA 94704-2636 |
| Mailing Address |
1659 E 32nd St Oakland CA 94602-1529 |
| Practice Telephone | 5108487070 |
| Mailing Telephone | 5104994838 |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 20352 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093186967 | Stacey Phelps | Counselor | 1799 Stumpf Blvd, Bldg 2 Ste 4-a, Gretna, LA 70056 | 2015-10-16 |
| Street Address |
2500 MILVIA ST STE 218 |
| City | BERKELEY |
| State | CA |
| Zip Code | 94704-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1821617168 | Michelle Nagal Hunt | Behavior Technician | 2080 Addison Street, #302, Berkeley, CA 94704 | 2020-04-15 |
| 1366097081 | Sabrina Barnett | Behavior Technician | 2080 Addison St, #302, Berkeley, CA 94704 | 2019-08-08 |
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1376014928 | Justin T Cooke | Specialist/Technologist | 2024 Durant Ave #508, Berkeley, CA 94704 | 2018-12-07 |
| 1972080158 | Cecilia Winfield | Student in an Organized Health Care Education/Training Program | 1918 University Ave., Suite 2b, Berkeley, CA 94704 | 2018-07-20 |
| 1952897332 | Jennifer Henry Henry | Naturopath | 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 | 2018-07-09 |
| 1497267967 | Merlenet Michelle Riley | Counselor | 2640 Martin Luther King, Berkeley, CA 94704 | 2017-10-24 |
| 1265951719 | Caitlin Mary Mcdonough | Student in an Organized Health Care Education/Training Program | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-09-15 |
| 1922525120 | Patrice Werling | Counselor | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-08-28 |
| Find all providers in zip 94704 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1154882835 | Isabella Maria Killion | Physician Assistant | 1100 The Alameda, Berkeley, CA 94707-2502 | 2019-03-26 |
| 1033676622 | Lucas Fogarty | Physician Assistant | 2222 Prince St, Berkeley, CA 94705-1819 | 2019-03-01 |
| 1720592009 | Tinebeta Daniel Mekonnen | Physician Assistant | 2762 Mathews St, Berkeley, CA 94702-2245 | 2017-11-25 |
| 1356878136 | Albert Ahoy | Physician Assistant | 2770 Acton St, Berkeley, CA 94702-2334 | 2017-05-11 |
| 1790210540 | Damara Kathleen Luce | Physician Assistant | 1515 Fairview St, Apt. C, Berkeley, CA 94703-2317 | 2017-04-28 |
| 1124222153 | Luz Munoz | Physician Assistant | 2031 Sixth St, Berkeley, CA 94710 | 2007-06-13 |
| 1538241260 | Annette Delilah Pizano | Physician Assistant | 2920 Telegraph Ave, Berkeley, CA 94705-2031 | 2006-10-20 |
| 1336158328 | Terri D Pagano | Physician Assistant | 2510 Webster St, Suite 300, Berkeley, CA 94705-2557 | 2006-08-07 |
| 1073533600 | Cecilia E. Brown | Physician Assistant | 2636 Telegraph Ave., Berkeley, CA 94704-3322 | 2006-07-19 |
| Find all providers in BERKELEY | ||||
Please comment or provide details below to improve the information on STACEY PHELPS.
| 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.