Active NPI
Stephanie Pukini
- Psychiatric/Mental Health Nurse Practitioner
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95000480
- Practice address
- 2592 N Santiago Blvd
Orange, CA 92867-1862 - Phone
- (855) 434-7763
- NPI assigned
- Jun 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95000480 | CA | Primary |
Addresses
Primary practice location
2592 N Santiago Blvd
Orange, CA 92867-1862
Mailing address
2592 N Santiago Blvd
Orange, CA 92867-1862
Phone (855) 434-7763
Other names 1
- Stephanie Marton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230901002057 | CA | Practitioner - Nurse Practitioner | 5991168205 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95000480 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J M Geiss DO Apc | Current | Accepting new patients | |
| California PHS PC | Current | Accepting new patients |
Locations
1420 E Palomar St
Chula Vista, CA 91913
7638 N Ingram Ave
#111A
Fresno, CA 93711
3415 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90034
Phone (424) 348-4558
1900 Coffee Rd
Modesto, CA 95355
Phone (209) 491-0904
520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266
2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271
3550 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3630
5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663
28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Santa Ana, CA
- NPI 1649932781
-
- Family Medicine Physician
- Santa Ana, CA
- NPI 1063825289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1003509241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2592 N SANTIAGO BLVD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928671862",
"telephone_number": "855-434-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2592 N SANTIAGO BLVD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928671862",
"telephone_number": "855-434-7763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUKINI",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-01",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95000480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "MARTON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.