Stephanie R Erickson, NP, CNM, MS

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

NP 11071 Issued in CA

Practice address

6600 Bruceville Rd
Sacramento, CA 95823-4671

Phone

(916) 688-6139

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1659345569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 BRUCEVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234671",
            "telephone_number": "916-688-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 BRUCEVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234671",
            "telephone_number": "916-688-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "NP, CNM, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "CNM 1400",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP 11071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1650 Response Rd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958154807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eva Rae Erickson
• Kyle Nelson Erickson, D.O.
• Michael R Erickson, PH.D.
• Ray Erickson, LCSW
• Robert Francis Erickson, MD
• Suzanne Gail Erickson, RAS/NCAC1
• Tracy Eileen Erickson, RN
• Jennifer M Ericson, PA-C
• Richard P. Ericson, MD
• Isaac E Erinmwingbovo, PHARMACIST

• Obstetrics & Gynecology Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.