Individual provider Active NPI

Staci Billy, RDHAP

  • Dental Hygienist
  • San Clemente, CA
National Provider Identifier
1649568130
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
RDHAP 356 Issued in CA
Practice address
4021 Calle Abril
San Clemente, CA 92673-2603
Phone
(949) 230-5763
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X RDHAP 356 CA Primary

Addresses

Primary practice location

4021 Calle Abril
San Clemente, CA 92673-2603

Mailing address

4021 Calle Abril
San Clemente, CA 92673-2603
Phone (949) 230-5763

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
RDHAP 356CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1649568130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 CALLE ABRIL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732603",
            "telephone_number": "949-230-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 CALLE ABRIL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732603",
            "telephone_number": "949-230-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLY",
        "first_name": "STACI",
        "credential": "RDHAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "RDHAP 356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.