Individual provider Active NPI

Amanda Joy Stallings, PHARMD

  • Pharmacist
  • Capitola, CA
National Provider Identifier
1992359236
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
65010 Issued in CA
Practice address
1750 41St Ave
Capitola, CA 95010-2503
Phone
(831) 476-0400
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 65010 CA Primary

Addresses

Primary practice location

1750 41St Ave
Capitola, CA 95010-2503

Mailing address

1750 41St Ave
Capitola, CA 95010-2503
Phone (831) 476-0400

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
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC PastSince Jul 28, 2019 Accepting new patients
Longs Drug Stores California LLC PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 2

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1992359236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 41ST AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102503",
            "telephone_number": "831-476-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 41ST AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102503",
            "telephone_number": "831-476-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "65010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.