Stacy Waung, CPNP-PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

95017212 Issued in CA

Practice address

2704 E Willow St
Signal Hill, CA 90755-2217

Phone

(562) 490-9900

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1154999787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 E WILLOW ST",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 E WILLOW ST",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552217",
            "telephone_number": "562-490-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUNG",
        "first_name": "STACY",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "95017212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Wailes Wallace
• Hannah Wallis, P.T., D.P.T.
• Ka'Juan Kepre Warren
• Euna Washington
• Tamara Washington, RN
• Wave Imaging LLC (Long Beach PET Imaging Center)
• Eric James Welker, ATC PTA
• Phynix Wilburn
• Lateanara Shonte Williams
• Carolyn Willis

• Pediatrics Physician in Signal Hill, CA
• Providers in Signal Hill, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.