Individual provider Active NPI

Stacy Lynn Holyfield, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Loma Linda, CA
National Provider Identifier
1912454208
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
24712 Issued in CA
Practice address
11370 Anderson St Ste 2100
Loma Linda, CA 92354-3450
Phone
(909) 558-2822
NPI assigned
Sep 5, 2016
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 24712 CA Primary
Speech-Language Pathologist 235Z00000X SLP8587 AZ

Addresses

Primary practice location

11370 Anderson St Ste 2100
Loma Linda, CA 92354-3450

Mailing address

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-4368

Other practice location 1

2521 Stockton Blvd Ste 7200
Sacramento, CA 95817-2207
Phone (916) 734-1530

Other practice location 2

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200930000828 AZ Practitioner - Qualified Speech Language Pathologist 7416376124 Reassigns benefits to 1 organization
I20260106001876 CA Practitioner - Qualified Speech Language Pathologist 7416376124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

3762 Tibbetts St
Riverside, CA 92506-2605
Phone (951) 686-2224

4646 Brockton Ave
Suite 103
Riverside, CA 92506-0103
Phone (909) 558-3111

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
24712CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 1, 2026 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 19, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 1, 2026 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 19, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

12021 Jacaranda Ave
Hesperia, CA 92345
Phone (909) 558-4207

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2600

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (760) 533-4541

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Organizations & group practices 6

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": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1912454208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 2100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 Stockton Blvd Ste 7200",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172207",
            "country_code": "US",
            "telephone_number": "916-734-1530",
            "fax_number": "916-703-5011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595452",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLYFIELD",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24712",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP8587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.