Individual provider Active NPI

Donna Kathleen Stachowicz, DNP, NP-C, CEN

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1033672969
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20897 Issued in CA
Practice address
7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone
(619) 876-4268
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 649059 CA
Family Nurse Practitioner 363LF0000X 20897 CA Primary

Addresses

Primary practice location

7675 Mission Valley Rd
San Diego, CA 92108-4429

Mailing address

704 River Rock Rd
Chula Vista, CA 91914-2429
Phone (267) 971-7976

Other identifiers 1

IdentifierTypeStateIssuer
20897OtherCABOARD OF NURSING - NP CERTIFICATE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20897CAMDClinical Social Worker
649059CAMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1033672969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 RIVER ROCK RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919142429",
            "telephone_number": "267-971-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "619-876-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHOWICZ",
        "first_name": "DONNA",
        "middle_name": "KATHLEEN",
        "credential": "DNP, NP-C, CEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "649059",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING - NP CERTIFICATE",
            "identifier": "20897",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.