Individual provider Active NPI

Stefanie Marie White, FNP

  • Family Nurse Practitioner
  • Chester, CA
National Provider Identifier
1306664511
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032337 Issued in CA
Practice address
199 Reynolds Road
Chester, CA 96020
Phone
(877) 227-3743
NPI assigned
Sep 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032337 CA Primary

Addresses

Primary practice location

199 Reynolds Road
Chester, CA 96020

Mailing address

PO Box 1703
Chester, CA 96020-1703

Other names 1

  • Stefanie Marie Tagudin Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241219003464 CA Practitioner - Nurse Practitioner 5597292151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seneca Healthcare DistrictGroup PAC ID 8820907140, 22 clinicians

Practice addresses (Care Compare)

130 Brentwood Dr
Chester, CA 96020
Phone (530) 258-2067

199 Reynolds Rd
PO Box 737
Chester, CA 96020

PO Box
Suite 737
Chester, CA 96020

PO Box
Suite 737
Chester, CA 96020-0737

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032337CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Healthcare District Current Accepting new patients
Seneca Healthcare District CurrentSince Dec 2, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1306664511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1703",
            "city": "CHESTER",
            "state": "CA",
            "postal_code": "960201703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 REYNOLDS ROAD",
            "city": "CHESTER",
            "state": "CA",
            "postal_code": "96020",
            "telephone_number": "877-227-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEFANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "TAGUDIN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chester, CA

Sources for this page

Verify at the official NPI Registry.