Active NPI
Stacey Ann Cobb, HAP 200
- Dental Hygienist
- Canyon Country, CA
National Provider Identifier
1205012986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- HAP 200
- Practice address
- 20108 Dorothy St
Canyon Country, CA 91351-3804 - Phone
- (661) 299-6602
- NPI assigned
- Jan 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | HAP 200 | CA | Primary |
Addresses
Primary practice location
20108 Dorothy St
Canyon Country, CA 91351-3804
Mailing address
20108 Dorothy St
Canyon Country, CA 91351-3804
Phone (661) 299-6602
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HAP 200 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1205012986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20108 DOROTHY ST",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913513804",
"telephone_number": "661-299-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20108 DOROTHY ST",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913513804",
"telephone_number": "661-299-6602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "STACEY",
"middle_name": "ANN",
"credential": "HAP 200",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-13",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "HAP 200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon Country, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.