Individual provider Active NPI

Stephanie Farrar, FNP-BC

  • Family Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1104520501
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025425 Issued in CA
Practice address
530 Esplanade Apt 409
Redondo Beach, CA 90277-4071
Phone
(262) 364-6483
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13770-33 WI
Family Nurse Practitioner 363LF0000X 95025425 CA Primary

Addresses

Primary practice location

530 Esplanade Apt 409
Redondo Beach, CA 90277-4071

Mailing address

530 Esplanade Apt 409
Redondo Beach, CA 90277-4071
Phone (262) 364-6483

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

State licenses

LicenseStateTypeSpecialty
95025425CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1104520501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 ESPLANADE APT 409",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774071",
            "telephone_number": "262-364-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 ESPLANADE APT 409",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774071",
            "telephone_number": "262-364-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRAR",
        "first_name": "STEPHANIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13770-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.