Individual provider Active NPI

Stacey Jones, NP

  • Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1073210514
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024020 Issued in CA
Practice address
2706 Senna LN
Palmdale, CA 93551-6998
Phone
(661) 526-3945
NPI assigned
Feb 15, 2023
Last updated
May 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95024020 CA Primary

Addresses

Primary practice location

2706 Senna LN
Palmdale, CA 93551-6998

Mailing address

2706 Senna LN
Palmdale, CA 93551-6998
Phone (661) 526-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621001592 CA Practitioner - Nurse Practitioner 0648713461 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024020CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Urgent Care Inc CurrentSince Feb 1, 2024 Accepting new patients
Palmdale Urgent Care Inc CurrentSince Apr 29, 2024 Accepting new patients

Locations

1331 W Avenue J
Ste 101
Lancaster, CA 93534
Phone (661) 899-5522

2270 E Palmdale Blvd
Ste F
Palmdale, CA 93550
Phone (661) 386-8983

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1073210514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 SENNA LN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935516998",
            "telephone_number": "661-526-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 SENNA LN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935516998",
            "telephone_number": "661-526-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "STACEY",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.