Individual provider Active NPI

Stephanie Cristal Mauricio

  • Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1346979416
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95403795 Issued in CA
Practice address
2515 W Pico Blvd
Los Angeles, CA 90006-4003
Phone
(213) 384-4555
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95403795 CA Primary

Addresses

Primary practice location

2515 W Pico Blvd
Los Angeles, CA 90006-4003

Mailing address

2515 W Pico Blvd
Los Angeles, CA 90006-4003
Phone (213) 384-4555

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

LicenseStateTypeSpecialty
95403795CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1346979416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064003",
            "telephone_number": "213-384-4555",
            "fax_number": "213-382-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064003",
            "telephone_number": "213-384-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "STEPHANIE",
        "middle_name": "CRISTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95403795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.