Stacey Merritt, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

694992 Issued in CA

Practice address

844 Pico Blvd
Santa Monica, CA 90405-1325

Phone

(310) 314-6200

Fax

(310) 314-1928

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clare Matrix

  dba CLARE Foundation Inc., dba MATRIX Institute on Addictions

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
  • NPI 1235349267
  NPD (past)
• Clare Matrix

  • Substance Abuse Rehabilitation Facility
  • Santa Monica, CA
  • NPI 1851645394
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1336604040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK KNOLL AVE UNIT 27",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011876",
            "telephone_number": "352-219-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051325",
            "telephone_number": "310-314-6200",
            "fax_number": "310-314-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "STACEY",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "694992",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "694992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Lynn Zlotnick Mercer
• Meredith Sagan, MD, a Professional Corporation (Holistic Psychiatry)
• Julie Mermelstein, LMFT
• Anita Marie Merrill
• Jennifer Robin Merritt, DDS
• Miramannee L. Merryman, PA
• Earl Anthony Mertz, PHARMD
• Sage Aimee Mervis, CCC
• Robert H Merz, M.D.
• Bita Mesri, PHD

• Licensed Vocational Nurse in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.