Roxanne Cara Stiles-Donnelly, NURSE PRACTITIONER

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

352429 Issued in CA

Practice address

3624 Delta Fair Blvd
Antioch, CA 94509-4006

Phone

(925) 779-5418

NPI assigned

Jan 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1073592416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 DELTA FAIR BLVD BLDG E",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094006",
            "telephone_number": "925-779-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 DELTA FAIR BLVD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094006",
            "telephone_number": "925-779-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES-DONNELLY",
        "first_name": "ROXANNE",
        "middle_name": "CARA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "352429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3624 Delta Fair Blvd Bldg E",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945094006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marlene Marie Stephens, MFT
• Myiesha N Stevens
• Ivan Stewart
• Juanita Stewart
• Srinithya Sthothrabhashyam
• Bryce Olivia Stinson
• Kayla Stockdale
• Channy Mak Streets, LCSW
• Kaitlin Streuli
• Ellen Strong, MFT

• Women's Health Nurse Practitioner in Antioch, CA
• Providers in Antioch, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.