Stacey Ann Marie Phillips, LVN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

263312 Issued in CA

Practice address

40700 California Oaks Rd
Suite 202
Murrieta, CA 92562-5795

Phone

(951) 894-5072

Fax

(951) 894-7324

NPI assigned

Jul 8, 2013

Last updated

Jul 8, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• WCHS- Temecula Valley Treatment Center

  • Nursing Care Agency
  • Murrieta, CA
  • NPI 1750623971
  Authorized official Same address or phone

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1801237888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD",
            "address_2": "SUITE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-894-5072",
            "fax_number": "951-894-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD",
            "address_2": "SUITE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625795",
            "telephone_number": "951-894-5072",
            "fax_number": "951-894-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "STACEY",
        "middle_name": "ANN MARIE",
        "name_prefix": "Miss",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "263312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330652055",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Phillips
• Lily Y. Phillips, MD
• Meghan Ann Phillips
• Raquel Phillips
• Robert Phillips, P.A.
• Teresa Phinazee
• Phoenix Rising Holistic Therapies LLC
• Physicians' Hospital of Murrieta, LLC (Loma Linda University Medical Center-Murrieta)
• Physicians' Hospital of Murrieta, LLC (Loma Linda University Medical Center-Murrieta POB Pharmacy)
• McKenna Elise Pica

• Licensed Practical Nurse in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Licensed Practical Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.