Organization Active NPI

Upstream Wellness

  • Nutrition Education Nutritionist
  • Boulder Creek, CA
National Provider Identifier
1881544633
Registry record updated Jan 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Legal business name
UPSTREAM WELLNESS
Practice address
120 Mayfair Rd
Boulder Creek, CA 95006-9401
Phone
(831) 337-8435
NPI assigned
Jan 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2026

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

Authorized official

Name
Mrs. Stephanie Michelle Carroll Strudley, CNSNPI 1659023034
Title
Functional Nutritionist
Phone
(831) 337-8435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X Primary

Addresses

Primary practice location

120 Mayfair Rd
Boulder Creek, CA 95006-9401

Mailing address

120 Mayfair Rd
Boulder Creek, CA 95006-9401
Phone (831) 337-8435

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1769817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769817600000",
    "number": "1881544633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MAYFAIR RD",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069401",
            "telephone_number": "831-337-8435",
            "fax_number": "831-331-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAYFAIR RD",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069401",
            "telephone_number": "831-337-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTREAM WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-31",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A",
        "authorized_official_last_name": "STRUDLEY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "MICHELLE CARROLL",
        "authorized_official_title_or_position": "FUNCTIONAL NUTRITIONIST",
        "authorized_official_telephone_number": "831-337-8435",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNS"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2026; 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.