Individual provider Active NPI

Stacy Marie Baldwin, FNP-BC

  • Family Nurse Practitioner
  • Fountain Valley, CA
National Provider Identifier
1114236395
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000726 Issued in CA
Practice address
17360 Brookhurst St
Fountain Valley, CA 92708-3720
Phone
(877) 844-0012
Fax
(714) 665-4680
NPI assigned
Oct 5, 2010
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000726 CA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NPF95033207 CA
Family Nurse Practitioner 363LF0000X NPF95033207 CA

Addresses

Primary practice location

17360 Brookhurst St
Fountain Valley, CA 92708-3720

Mailing address

17360 Brookhurst St
Fountain Valley, CA 92708-3720
Phone (877) 844-0012

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20140905002541 CA Practitioner - Nurse Practitioner 7113106972 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NPF95033207CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Medical Care of California CurrentSince Oct 17, 2024 Accepting new patients
North County Health Project Inc Current Accepting new patients
North County Health Project Inc CurrentSince Jun 10, 2025 Accepting new patients
North County Health Project Inc CurrentSince Jun 10, 2025 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Harbor Psychiatry & Mental Health, Professional Corporation PastSince Jul 7, 2015 Accepting new patients

Locations

415 N Crescent Dr
Ste 320
Beverly Hills, CA 90210
Phone (415) 510-2755

3998 Vista Way
Ste 204
Oceanside, CA 92056
Phone (619) 726-2500

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700

Interoperability endpoints

  • Direct secure messaging: sbaldwin148409@direct.llu.edu
  • Direct secure messaging: sbaldwin798174@direct.ochin.org

Organizations & group practices 6

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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1114236395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "877-844-0012",
            "fax_number": "714-665-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "877-844-0012",
            "fax_number": "714-665-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000726",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NPF95033207",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF95033207",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.