Individual provider Active NPI

Stacy Diane Niusulu

  • Case Manager/Care Coordinator
  • Sacramento, CA
National Provider Identifier
1215893524
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1125 9TH St FL 2
Sacramento, CA 95814-3643
Phone
(916) 291-7577
Fax
(916) 485-6814
NPI assigned
Dec 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CA Primary

Addresses

Primary practice location

1125 9TH St FL 2
Sacramento, CA 95814-3643

Mailing address

1125 9TH St FL 2
Sacramento, CA 95814-3643
Phone (916) 291-7577

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

NPI Registry JSON

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1215893524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 9TH ST FL 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143643",
            "telephone_number": "916-291-7577",
            "fax_number": "916-485-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 9TH ST FL 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143643",
            "telephone_number": "916-291-7577",
            "fax_number": "916-485-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIUSULU",
        "first_name": "STACY",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.