Individual provider Active NPI

Holly Colleen Staples, FNP

  • Family Nurse Practitioner
  • Encinitas, CA
National Provider Identifier
1144880329
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011853 Issued in CA
Practice address
2210 Encinitas Blvd Ste N
Encinitas, CA 92024-4376
Phone
(858) 280-1899
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 95011853 CA Primary

Addresses

Primary practice location

2210 Encinitas Blvd Ste N
Encinitas, CA 92024-4376

Mailing address

5134 Whitman Way Apt 211
Carlsbad, CA 92008-4658
Phone (858) 280-1899

Other practice location 1

2425 Camino Del Rio S Ste 180
San Diego, CA 92108-3746
Phone (858) 280-1899

Other practice location 2

9735 Campo Rd Ste 270
Spring Valley, CA 91977-1490
Phone (619) 465-4982

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
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1144880329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5134 WHITMAN WAY APT 211",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084658",
            "telephone_number": "858-280-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 ENCINITAS BLVD STE N",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244376",
            "telephone_number": "858-280-1899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 Camino Del Rio S Ste 180",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083746",
            "country_code": "US",
            "telephone_number": "858-280-1899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9735 Campo Rd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "CA",
            "postal_code": "919771490",
            "country_code": "US",
            "telephone_number": "619-465-4982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "HOLLY",
        "middle_name": "COLLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.