Individual provider Active NPI

Stacy Jean Zambrano

  • Internal Medicine Physician
  • Concord, CA
National Provider Identifier
1992094171
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A125232 Issued in CA
Practice address
2000 Sierra Road
Concord, CA 94518
Phone
(925) 363-2000
NPI assigned
Mar 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A125232 CA Primary

Addresses

Primary practice location

2000 Sierra Road
Concord, CA 94518

Mailing address

2000 Sierra Road
Concord, CA 94518
Phone (925) 363-2000

Other practice location 1

4150 V St # 1110
Sacramento, CA 95817-1460
Phone (619) 370-3316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150227002053 CA Practitioner - Internal Medicine 8426374976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

2000 Sierra Rd
Concord, CA 94518-2905
Phone (925) 363-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A125232CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Multi-Specialty CurrentSince Jan 1, 2023 Accepting new patients
La Clinica de la Raza Inc CurrentSince Jan 1, 2023 Accepting new patients
Permanente Medical Group Inc Multi-Specialty CurrentSince Dec 16, 2014 Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 16, 2014 Accepting new patients
La Clinica de la Raza Inc Multi-Specialty Current Accepting new patients
Permanente Medical Group Inc Multi-Specialty Current Accepting new patients
La Clinica de la Raza, Inc. Multi-Specialty Past Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1992094171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SIERRA ROAD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-363-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SIERRA ROAD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-363-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St # 1110",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171460",
            "country_code": "US",
            "telephone_number": "619-370-3316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMBRANO",
        "first_name": "STACY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A125232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.