Stacy Marie Catalon, M.D.
Individual provider Active NPI Pediatrics Physician · Riverside, CA
NPI 1023453081 · NPPES record last updated Apr 11, 2025
Key facts
- NPI
- 1023453081
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A134160 (CA)
- Practice address
- 19314 Jesse LN
Riverside, CA 92508-5069 - Phone
- (951) 782-3640
- Fax
- (951) 776-4515
- NPI assigned
- May 5, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180315002443 | CA | Practitioner - Pediatric Medicine | 8426310103 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A134160 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Medical Clinic, Inc | Pediatrics | Current |
Accepting new patients |
| Riverside Medical Clinic, Inc | Pediatrics | Current |
Accepting new patients |
| Riverside Medical Clinic, Inc | Current | Accepting new patients | |
| Riverside Medical Clinic, Inc | Pediatrics | Past | Accepting new patients |
| Riverside Medical Clinic, Inc | Pediatrics | Past | Accepting new patients |
Locations
19314 Jesse Ln
Riverside, CA 92508
Phone (951) 782-3640
19314 Jesse Ln
Ste 100
Riverside, CA 92508
Phone (951) 776-4503
3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A134160 | CA | Yes |
Addresses
Primary practice location
19314 Jesse LN
Riverside, CA 92508-5069
Mailing address
19314 Jesse LN
Riverside, CA 92508-5069
Phone (951) 782-3640
Other providers in Riverside, CA
- Veronica Castro
- Catalina Castronuovo
- Monica Castruita
- Nissa L Casuga
- Samuel Roy Atiga Catalon
- Karina Catapang
- Ashley Cates
- Christine M. Catipon
- Jessica Cauich
- Amy Dawn Causey
All providers in Riverside, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.