Active NPI
Jesse Tyler Stief
- Independent Duty Corpsman
- San Diego, CA
National Provider Identifier
1841918489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 34101 Farenholt Ave
San Diego, CA 92134-7000 - Phone
- (626) 691-8587
- NPI assigned
- Aug 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
34101 Farenholt Ave
San Diego, CA 92134-7000
Mailing address
2520 Midway Rd Ste 400
Virginia Beach, VA 23459-3324
Phone (757) 917-6091
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1841918489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 MIDWAY RD STE 400",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234593324",
"telephone_number": "757-917-6091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34101 FARENHOLT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921347000",
"telephone_number": "626-691-8587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIEF",
"first_name": "JESSE",
"middle_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-19",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.