Individual provider Active NPI

Stacy Ann Simmons, CPHT

  • Pharmacy Technician
  • Orange, CA
National Provider Identifier
1649676347
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
Practice address
505 City Pkwy W
Orange, CA 92868-2924
Phone
(657) 235-6778
Fax
(714) 338-3132
NPI assigned
Nov 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X Primary

Addresses

Primary practice location

505 City Pkwy W
Orange, CA 92868-2924

Mailing address

505 City Pkwy W
Orange, CA 92868-2924
Phone (657) 235-6778

Other identifiers 1

IdentifierTypeStateIssuer
520107010118472OtherCAPTCB

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

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1649676347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CITY PKWY W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682924",
            "telephone_number": "657-235-6778",
            "fax_number": "714-338-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CITY PKWY W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682924",
            "telephone_number": "657-235-6778",
            "fax_number": "714-338-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTCB",
            "identifier": "520107010118472",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.