Individual provider Active NPI

Stefaniya Tabanlieva, N.P.

  • Gerontology Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1508617630
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95027914 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11029241 FL
Acute Care Nurse Practitioner 363LA2100X 11029241 FL
Gerontology Nurse Practitioner 363LG0600X 95027914 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (800) 926-8273

Other practice location 1

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273

Other practice location 2

1000 Fivepoint Ste A
Irvine, CA 92618-2621
Phone (949) 671-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com Direct CITY OF HOPE MEDICAL FOUNDATION

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
I20251112003611 CA Practitioner - Nurse Practitioner 4284176504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

1000 Fivepoint
Irvine, CA 92618-2377
Phone (949) 671-4673

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

Hospital & facility affiliations

  • City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11029241FLMDNurse Practitioner
11029241FLMDAcute Care Nurse Practitioner
95027914CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Nurse Practitioner CurrentSince Nov 8, 2025 Accepting new patients
City of Hope Medical Foundation CurrentSince Oct 1, 2025 Accepting new patients
Regents of the University of California CurrentSince Nov 8, 2025 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1000 Fivepoint
Irvine, CA 92618
Phone (888) 333-4673

1000 Fivepoint
Ste A
Irvine, CA 92618
Phone (888) 333-4673

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 57326
Los Angeles, CA 90074

1601 Avocado Ave
Newport Beach, CA 92660
Phone (949) 763-2204

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

Interoperability endpoints

  • Direct secure messaging: stabanlieva272739@cityofhope.direct-ci.com
  • Direct secure messaging: direct@cityofhope.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1508617630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "La Jolla",
            "state": "CA",
            "postal_code": "920371300",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Fivepoint Ste A",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926182621",
            "country_code": "US",
            "telephone_number": "949-671-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABANLIEVA",
        "first_name": "STEFANIYA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11029241",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11029241",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95027914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Fivepoint",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926182377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.