MRS. STACY ANN VENCILL (NPI# 1629110655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629110655 |
| Entity Type | Individual |
| Full Name | MRS. STACY ANN VENCILL |
| Other Name | MS. STACY ANN HECKMAN |
| Credential | PA-C |
| Practice Address |
4870 Barranca Pkwy 350 Irvine CA 92604-4709 |
| Mailing Address |
Po Box 15243 Newport Beach CA 92659-5243 |
| Practice Telephone | 9494516060 |
| Practice Fax Number | 9494516070 |
| Mailing Telephone | 9495744600 |
| Mailing Fax Number | 9495744680 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2010-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA18107 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4870 BARRANCA PKWY 350 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-4709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568437440 | Amdc | Family Medicine | 4870 Barranca Pkwy, Suite 110, Irvine, CA 92604-4709 | 2006-02-22 |
| 1215327077 | Victoria E Sun | Registered Nurse | 4870 Barranca Pkwy, Suite 110, Irvine, CA 92604-4709 | 2015-02-02 |
| 1275871246 | Jamie Beth Sanders | Nurse Practitioner | 4870 Barranca Pkwy, Ste 110, Irvine, CA 92604-4709 | 2013-01-24 |
| 1649537168 | Christine Ann Russo | Physical Therapist | 4870 Barranca Pkwy, #340, Irvine, CA 92604-4709 | 2012-04-22 |
| 1629398490 | Jacqueline Leon | Pediatrics | 4870 Barranca Pkwy, Suite 300, Irvine, CA 92604-4709 | 2010-06-03 |
| 1053645333 | Marie J. Galvan Renella | Physician Assistant | 4870 Barranca Pkwy, Suite 305, Irvine, CA 92604-4709 | 2009-09-19 |
| 1942435433 | Jennifer Lee Altman Birkhauser | Pediatrics | 4870 Barranca Pkwy, Ste 300, Irvine, CA 92604-4709 | 2009-05-27 |
| 1619117843 | Nancy G Murray | Physician Assistant | 4870 Barranca Pkwy, Suite #350, Irvine, CA 92604-4709 | 2009-02-27 |
| 1124263280 | Irvine Internal Medical Group, Inc. | Non-Pharmacy Dispensing Site | 4870 Barranca Pkwy, 330, Irvine, CA 92604-4709 | 2008-12-03 |
| 1629245790 | Tara O'connell | Emergency Medicine | 4870 Barranca Pkwy, Ecu Dept, Irvine, CA 92604-4709 | 2008-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228445 | Tiffany P Zaken | Physician Assistant | 4968 Booth Cir Ste 101, Irvine, CA 92604-3366 | 2019-11-05 |
| 1104294305 | Holly Boyce Demetrescu | Physician Assistant | 17 Foxglove Way, Irvine, CA 92612-2712 | 2015-09-04 |
| 1477995504 | Nelson Aguilar | Physician Assistant | 8134 Spectrum, Irvine, CA 92618-7359 | 2013-07-17 |
| 1821396862 | Angeline Cici Chen | Physician Assistant | 17305 Von Karman Ave Ste 101-107, Irvine, CA 92614-0963 | 2011-02-28 |
| 1578868998 | Y Nha Thi Thi Dinh | Physician Assistant | 17305 Von Karman Ave, Irvine, CA 92614-0963 | 2011-01-14 |
| 1427199751 | Chad Serrao | Physician Assistant | 6825 Quail Hill Pkwy, Irvine, CA 92603-4234 | 2007-02-09 |
| 1700936887 | Shirley M Gray | Physician Assistant | Uci Student Health Ctr, 501 Student Health, Irvine, CA 92697-5200 | 2007-01-11 |
| 1144252230 | William Jason | Physician Assistant | 2362 Morse Ave, Irvine, CA 92614-6234 | 2006-07-07 |
| 1063783413 | Evelyn Lillian Nguyen | Physician Assistant | 2192 Martin Ste 110, Irvine, CA 92612-1484 | 2012-01-17 |
| 1487949251 | Samantha Jill Cohen | Physician Assistant | 17264 Red Hill Ave, Irvine, CA 92614-5628 | 2011-06-09 |
| Find all providers in IRVINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.