Stephany Lavigne
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Orange, CA
NPI 1669065660 · NPPES record last updated Nov 16, 2023
Key facts
- NPI
- 1669065660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2017961 (CA)
- Practice address
- 2050 W Chapman Ave Ste 201
Orange, CA 92868-2649 - Phone
- (949) 565-4733
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Psychological Services Inc
Eagan Medical Group Inc
Practice addresses (Care Compare)
30495 Canwood St
Suite 101
Agoura Hills, CA 91301-4331
Phone (818) 707-7366
7677 Ctr Ave
Suite 405
Huntington Beach, CA 92647-3098
Phone (714) 369-8037
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210428002767 | CA | Practitioner - Nurse Practitioner | 7012326200 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017961 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagan Medical Group, Inc. | Current |
Accepting new patients | |
| Ehab Yacoub MD Inc. | Current |
Accepting new patients | |
| Family Psychological Services Inc | Current |
Accepting new patients |
Locations
30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366
1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113
7677 Center Ave
Ste 405
Huntington Beach, CA 92647
Phone (714) 369-8037
18401 Von Karman Ave
Ste 500
Irvine, CA 92612
Phone (305) 343-5995
23961 Calle de la Magdalena
Ste 420
Laguna Hills, CA 92653
Phone (833) 501-3079
100 Oceangate
Ste 610
Long Beach, CA 90802
Phone (717) 476-4282
10780 Santa Monica Blvd
Ste 235
Los Angeles, CA 90025
1000 Quail St
Ste 200
Newport Beach, CA 92660
Phone (714) 369-8052
17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929
2050 W Chapman Ave
Ste 201
Orange, CA 92868
Phone (214) 751-8987
3848 W Carson St
Ste 103
Torrance, CA 90503
Phone (310) 897-5889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2017961 | CA | Yes |
Addresses
Primary practice location
2050 W Chapman Ave Ste 201
Orange, CA 92868-2649
Mailing address
2050 W Chapman Ave Ste 201
Orange, CA 92868-2649
Other providers in Orange, CA
- Victoria P Laughlin
- Kristen Marie Nolan Launier
- Victoria Laurente
- Sayeh Lavasani
- Michael Peter Lavigne
- Caitlin Amelia Law
- James H. Law
- Kenny Law
- Lawrence David Wagman MD Professional Corporation
- Amy Lawrence
All providers in Orange, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.