Individual provider Active NPI

Haillie Ann Stober, CMA

  • Case Manager/Care Coordinator
  • Lake Elsinore, CA
National Provider Identifier
1700239084
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
31764 Casino Dr
Suite 300
Lake Elsinore, CA 92530-4571
Phone
(951) 471-4645
Fax
(951) 471-4687
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

31764 Casino Dr
Suite 300
Lake Elsinore, CA 92530-4571

Mailing address

31764 Casino Dr
Suite 300
Lake Elsinore, CA 92530-4571
Phone (951) 471-4645

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
Credentials
Certified Medical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1700239084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR",
            "address_2": "SUITE 300",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304571",
            "telephone_number": "951-471-4645",
            "fax_number": "951-471-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR",
            "address_2": "SUITE 300",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304571",
            "telephone_number": "951-471-4645",
            "fax_number": "951-471-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOBER",
        "first_name": "HAILLIE",
        "middle_name": "ANN",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.