Stacie Sanborn, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11031 Issued in CA

Practice address

520 Walnut Ave
Vacaville, CA 95688-5335

Phone

(530) 383-4958

NPI assigned

Dec 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cit Clinics Inc.

  • Anesthesiology Physician
  • Corte Madera, CA
  • NPI 1720638505
  Medicare reassignment NPD
• JJM Integrative Health Advanced Nursing Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Vacaville, CA
  • NPI 1477316057
  Medicare reassignment NPD

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1568791978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WALNUT AVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956885335",
            "telephone_number": "530-383-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WALNUT AVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956885335",
            "telephone_number": "530-383-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "STACIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "CA",
            "license": "3247",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "11031",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "11031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam'S Club Optical
• Mara Stephanie Leon Sammartino, LCSW
• Sams West Inc
• Ericka Samson, RN, ATC
• Mary Roanne De Guia Samuels, LMFT
• Antonio Sanchez II, ANMT,CMT
• Celia Maria Sanchez
• Emily Ann Sandau
• Bruce D. Sanders, PH.D.
• Stephanie Sanders, DO

• Psychiatric/Mental Health Nurse Practitioner in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.