Individual provider Active NPI

Prudence Iona Stennett-Anderson, FNPC

  • Family Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1396935938
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
583572 Issued in CA
Practice address
1543 E Palmdale Blvd
Ste C
Palmdale, CA 93550-2000
Phone
(661) 274-1200
Fax
(661) 274-1199
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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 583572 CA Primary

Addresses

Primary practice location

1543 E Palmdale Blvd
Ste C
Palmdale, CA 93550-2000

Mailing address

1543 E Palmdale Blvd
Ste C
Palmdale, CA 93550-2000
Phone (661) 274-1200

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
583572CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients
Roy Medical Group, Inc. PastSince Jun 2, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1396935938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 E PALMDALE BLVD",
            "address_2": "STE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502000",
            "telephone_number": "661-274-1200",
            "fax_number": "661-274-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 E PALMDALE BLVD",
            "address_2": "STE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502000",
            "telephone_number": "661-274-1200",
            "fax_number": "661-274-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENNETT-ANDERSON",
        "first_name": "PRUDENCE",
        "middle_name": "IONA",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "583572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.