Kerry Lynn Stavinoha

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

6203369 Issued in CA

Practice address

1409 Dentro de Lomas
Bonsall, CA 92003-6811

Phone

(760) 390-5485

NPI assigned

Jul 15, 2022

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2022.

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1154055085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 DENTRO DE LOMAS",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920036811",
            "telephone_number": "760-390-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 DENTRO DE LOMAS",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920036811",
            "telephone_number": "760-390-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVINOHA",
        "first_name": "KERRY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "6203369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bonsall, CA
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.