Stacey Adelson, NP
Individual provider Active NPI Nurse Practitioner · San Mateo, CA
NPI 1104951797 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104951797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN2818272 (CA)
- Practice address
- 222 W 39TH Ave
San Mateo, CA 94403-4364 - Phone
- (650) 573-2222
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2818272 | CA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN2818272 | CA | Yes |
Addresses
Primary practice location
222 W 39TH Ave
San Mateo, CA 94403-4364
Mailing address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN281872 | Medicaid | CA |
Other providers in San Mateo, CA
- Nikki Adams
- Shelley L Adams
- Addus Healthcare, Inc.
- Addus Healthcare, Inc.
- Leila Adel
- Frederick William Adler
- Kent Marc-Josef Adler
- Marie Louise Paraino Adorable
- Cindy Adrian
- Adrienne McGrael Souders MD Inc
All providers in San Mateo, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.