Individual provider Active NPI

Stacy Vanessa Luna, FNP-C

  • Family Nurse Practitioner
  • Montebello, CA
National Provider Identifier
1144080946
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029456 Issued in CA
Practice address
833 W Whittier Blvd
Montebello, CA 90640-4735
Phone
(323) 712-4811
Fax
(844) 302-8678
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029456 CA Primary

Addresses

Primary practice location

833 W Whittier Blvd
Montebello, CA 90640-4735

Mailing address

833 W Whittier Blvd
Montebello, CA 90640-4735
Phone (323) 712-4811

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
I20250624002779 CA Practitioner - Nurse Practitioner 1557873692 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029456CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
R Ruiz M D a Professional Corporation CurrentSince Mar 29, 2025 Accepting new patients

Locations

833 W Whittier Blvd
Montebello, CA 90640
Phone (323) 266-1000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBGFBD/Endpoint/DBGFBD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1144080946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404735",
            "telephone_number": "323-712-4811",
            "fax_number": "844-302-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404735",
            "telephone_number": "323-712-4811",
            "fax_number": "844-302-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "STACY",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.