Individual provider Active NPI

Stacey Marie Negrete, PNP

  • Pediatric Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1447689609
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95000089 Issued in CA
Practice address
25485 Medical Center Dr
Suite 220
Murrieta, CA 92562-6900
Phone
(951) 461-9300
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95000089 CA Primary

Addresses

Primary practice location

25485 Medical Center Dr
Suite 220
Murrieta, CA 92562-6900

Mailing address

3860 Calle Fortunada
Suite 200
San Diego, CA 92123-4800
Phone (858) 636-4800

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
95000089CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Children's Primary Care Medical Group, 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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1447689609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234800",
            "telephone_number": "858-636-4800",
            "fax_number": "858-636-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25485 MEDICAL CENTER DR",
            "address_2": "SUITE 220",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626900",
            "telephone_number": "951-461-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRETE",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95000089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.