Individual provider Active NPI

Stephanie Hwa, RN, NP

  • Gerontology Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1477894780
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95000733 Issued in CA
Practice address
1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644
Phone
(714) 446-5590
NPI assigned
Mar 12, 2013
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 847802 CA
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X 95000733 CA Primary

Addresses

Primary practice location

1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644

Mailing address

4241 W Kling St Apt 30
Burbank, CA 91505-3721
Phone (714) 469-3298

Other practice location 1

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151215002033 CA Practitioner - Nurse Practitioner 9335440460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2600
Fullerton, CA 92835-3644
Phone (714) 446-5260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jan 21, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Jan 21, 2026 Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2600
Fullerton, CA 92835
Phone (714) 446-5260

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1477894780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 W KLING ST APT 30",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053721",
            "telephone_number": "714-469-3298",
            "fax_number": "818-847-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2600",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353644",
            "telephone_number": "714-446-5590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Buena Vista St",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915054809",
            "country_code": "US",
            "telephone_number": "818-847-4560",
            "fax_number": "818-847-3795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWA",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "847802",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95000733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.