Individual provider Active NPI

Stephany Lavigne

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
National Provider Identifier
1669065660
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2017961 Issued in CA
Practice address
2050 W Chapman Ave Ste 201
Orange, CA 92868-2649
Phone
(949) 565-4733
NPI assigned
Feb 19, 2021
Last updated
Nov 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2017961 CA Primary

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

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
I20210428002767 CA Practitioner - Nurse Practitioner 7012326200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 6507019379, 16 clinicians
Eagan Medical Group IncGroup PAC ID 6608136056, 8 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017961CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince May 1, 2021 Accepting new patients
Family Psychological Services Inc CurrentSince Sep 30, 2021 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 (909) 200-7370

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) 210-9265

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1669065660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 W CHAPMAN AVE STE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W CHAPMAN AVE STE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682649",
            "telephone_number": "949-565-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIGNE",
        "first_name": "STEPHANY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2017961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.