Katelyn Amanda Stults, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95027104 Issued in CA

Practice address

3742 Katella Ave Ste 302
Los Alamitos, CA 90720-3172

Phone

(562) 702-3825

Fax

(323) 302-4581

NPI assigned

Oct 4, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1144827072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18316 TAYLOR CT",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045450",
            "telephone_number": "610-513-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 KATELLA AVE STE 302",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203172",
            "telephone_number": "562-702-3825",
            "fax_number": "323-302-4581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3742 Katella Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Los Alamitos",
            "state": "CA",
            "postal_code": "907203172",
            "country_code": "US",
            "telephone_number": "562-936-0292",
            "fax_number": "562-936-1943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULTS",
        "first_name": "KATELYN",
        "middle_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie a. Dodson DDS Ms
• Stephen Michael Eskaros, M.D., Inc.
• Mara L Stevens, PA-C
• Robin Strickland, BA
• Renee Stroffe, PA-C
• Edy Stumpf, MFT
• Mallory Anne Stuparich, M.D.
• Anna Sturz
• Maricruz Suber, FNP-C
• Suburban Drug Co a Corp

• Family Nurse Practitioner in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.