Individual provider Active NPI

Theresa M Stephany, RN

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1407917180
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
338123 Issued in CA
Practice address
2865 Logan Ave
San Diego, CA 92113
Phone
(619) 232-4357
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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 338123 CA Primary

Addresses

Primary practice location

2865 Logan Ave
San Diego, CA 92113

Mailing address

2865 Logan Ave
San Diego, CA 92113-2411
Phone (619) 232-4357

Other practice location 1

489 Clementina St
San Francisco, CA 94103-4106
Phone (415) 495-6071 ext. 28

Other practice location 2

545 Laurel St
San Diego, CA 92101-1634
Phone (619) 233-4399

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
338123CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Past 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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1407917180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132411",
            "telephone_number": "619-232-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-232-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "489 Clementina St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941034106",
            "country_code": "US",
            "telephone_number": "415-495-6071 x28",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Laurel St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921011634",
            "country_code": "US",
            "telephone_number": "619-233-4399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHANY",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "338123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.