Individual provider Active NPI

Stacyann Andaya, NP

  • Family Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1649893660
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014595 Issued in CA
Practice address
2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone
(925) 932-6330
Fax
(925) 932-0139
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 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 95014595 CA Primary

Addresses

Primary practice location

2637 Shadelands Dr
Walnut Creek, CA 94598-2512

Mailing address

2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 932-6330

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
I20200803003194 CA Practitioner - Nurse Practitioner 8628493996 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System CurrentSince Sep 25, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 10, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 10, 2020 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2809 Olive Hwy
Oroville, CA 95966
Phone (530) 532-8654

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

100 Hospital Dr
Vallejo, CA 94589
Phone (707) 551-3400

Interoperability endpoints

  • Direct secure messaging: sandaya446940@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1649893660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-932-6330",
            "fax_number": "925-932-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-932-6330",
            "fax_number": "925-932-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAYA",
        "first_name": "STACYANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.