Stephanie Lisette Bedolla, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95002835 Issued in CA

Practice address

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Phone

(707) 559-7500

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Petaluma Health Center Inc 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (6 of 7)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: sbedolla800653@direct.ochin.org

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.

• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1588656268

  CA

  Medicare reassignment Care Compare group NPD
• Petaluma Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1437918406
  Care Compare group NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762

  CA

  Medicare reassignment
• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Point Reyes Station, CA
  • NPI 1053420844
  Care Compare group
• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Rohnert Park, CA
  • NPI 1669870739
  Care Compare group
• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Bolinas, CA
  • NPI 1760584049
  Care Compare group
• Petaluma Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1275283343
  Care Compare group
• Petaluma Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1588422604
  Care Compare group
• Petaluma Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1801655873
  Care Compare group
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1265717565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16977 Healdsburg Ave",
            "address_purpose": "LOCATION",
            "city": "Healdsburg",
            "state": "CA",
            "postal_code": "954483261",
            "country_code": "US",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 Gilbert St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946114657",
            "country_code": "US",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDOLLA",
        "first_name": "STEPHANIE",
        "middle_name": "LISETTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "NPP37728",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2275566",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95002835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11009205/A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SB90061",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Felicia Bean, NP
• Beck Chiropractic Professional Corporation
• Dewayne Albert Beck, HSC
• Elizabeth Beck
• Alexis Feineigle Becker, CNM
• Binbin Beecher
• Sharina S. Belani, MD
• Baxter Bell Jr., M.D.
• Lisa Bell, P.T.
• Jaime Benavides

• All providers in Petaluma, CA
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.