Individual provider Active NPI

Ashley Nichole Stafford

  • Family Nurse Practitioner
  • San Marcos, CA
National Provider Identifier
1538828355
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014725 Issued in CA
Practice address
400 Craven Rd
San Marcos, CA 92078-4201
Phone
(760) 510-4460
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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 95014725 CA Primary

Addresses

Primary practice location

400 Craven Rd
San Marcos, CA 92078-4201

Mailing address

40438 Yardley CT
Temecula, CA 92591-7028
Phone (951) 764-1352

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
I20220226000311 CA Practitioner - Nurse Practitioner 1850785346 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Feb 10, 2022 Accepting new patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Jan 4, 2022 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Jan 4, 2022 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

8850 Valley View St
Buena Park, CA 90620
Phone (714) 827-7321

2510 El Camino Real
Carlsbad, CA 92008
Phone (760) 729-8941

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone (619) 461-4411

987 E Hillsdale Blvd
Foster City, CA 94404
Phone (650) 570-4631

2456 S Grove Ave
Ontario, CA 91761
Phone (909) 947-9390

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

1350 Florin Rd
Sacramento, CA 95822
Phone (916) 392-1004

1900 19th Ave
San Francisco, CA 94116
Phone (415) 664-1834

2514 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-1431

2455 San Ramon Valley Blvd
San Ramon, CA 94583
Phone (925) 820-7325

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3064

2791 Agoura Rd
Westlake Village, CA 91361
Phone (800) 523-4042

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.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1538828355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40438 YARDLEY CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925917028",
            "telephone_number": "951-764-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CRAVEN RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784201",
            "telephone_number": "760-510-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "ASHLEY",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.