Individual provider Active NPI

Stacey K Douwes

  • Student in an Organized Health Care Education/Training Program
  • Indio, CA
National Provider Identifier
1003771114
Registry record updated Dec 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
47915 Oasis St
Indio, CA 92201-6950
Phone
(760) 835-5601
NPI assigned
Dec 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

47915 Oasis St
Indio, CA 92201-6950

Mailing address

1207 Palmas RDG
Palm Springs, CA 92262-1259
Phone (760) 835-5601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766188800000",
    "number": "1003771114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 PALMAS RDG",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621259",
            "telephone_number": "760-835-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47915 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016950",
            "telephone_number": "760-835-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUWES",
        "first_name": "STACEY",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-20",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.