STACEY DANIELLE LITTLE (NPI# 1831396415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831396415 |
| Entity Type | Individual |
| Full Name | STACEY DANIELLE LITTLE |
| Credential | PA-C |
| Practice Address |
1250 6th Ave Ste 100 San Diego CA 92101-4368 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6195152430 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6199064564 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA16457 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LIC | 16457 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 823 Gateway Center Way, San Diego, CA 921024541 | 6199064623 | 6199064564 |
| Street Address |
1250 6TH AVE STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92101-4368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902945199 | Norma Quiroz | Marriage & Family Therapist | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2007-02-05 |
| 1902336837 | Kristin Kupka Webster | Social Worker | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2017-06-13 |
| 1952747875 | Yuliya Eduardovna Proosaselts | Psychiatry & Neurology | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2013-05-18 |
| 1083963094 | Sandra Shan Lim | Psychiatry & Neurology | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2012-09-05 |
| 1285875427 | Colleen Virginia Worth | Nurse Practitioner | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2009-03-18 |
| 1851544340 | Kelly Marie Mc Henry | Social Worker | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2008-10-28 |
| 1568588325 | Ruth Anne Gillis | Marriage & Family Therapist | 1250 6th Ave Ste 100, San Diego, CA 92101-4368 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
| 1235752585 | Liminal Solutions LLC | Home Health | 845 15th Street, Floors 1-4, San Diego, CA 92101 | 2020-05-21 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1700380086 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1850 5th Ave, San Diego, CA 92101 | 2018-03-21 |
| 1013436161 | Yasmin Galicianava | Student in an Organized Health Care Education/Training Program | 734 Tenth Ave, San Diego, CA 92101 | 2017-09-10 |
| 1487172516 | Jessica Roach | Counselor | 1045 9th Avenue, San Diego, CA 92101 | 2017-09-09 |
| 1699204099 | Lisa Nunez | Student in an Organized Health Care Education/Training Program | 1963 4th Avenue, San Diego, CA 92101 | 2017-06-08 |
| 1356882245 | Dajah Mone't Lockett | Counselor | 2535 Kettner Blvd Suite 1a4, San Diego, CA 92101 | 2017-03-13 |
| 1649718495 | Luigi Bunyi | Behavior Technician | 501 W Broadway Suite 800, San Diego, CA 92101 | 2017-02-01 |
| Find all providers in zip 92101 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528610870 | Josephine Hoa Ngoc Mai | Physician Assistant | 3050 Rue Dorleans Unit 291, San Diego, CA 92110-5904 | 2019-07-16 |
| 1962966309 | Tashina Jessica Kraintz | Physician Assistant | 10431 Caminito Alvarez, San Diego, CA 92126-5838 | 2019-01-30 |
| 1801314042 | Erika Dimitra Couris | Physician Assistant | 3969 Fourth Ave, #301, San Diego, CA 92103-9210 | 2017-09-08 |
| 1871859421 | Lisa Nakhleh Boyd | Physician Assistant | 2999 Health Center Drive, San Diego, CA 92123 | 2012-04-09 |
| 1760759104 | Brandon William Schroth | Physician Assistant | 357051 Nasni, Commander Naval Air Forces, San Diego, CA 92135-7051 | 2011-11-30 |
| 1891080750 | Jennifer K Nguyen | Physician Assistant | 1466 Mariposa Street, San Diego, CA 92114-3612 | 2011-06-17 |
| 1942510698 | Laurie Anne Reeves | Physician Assistant | 6367 Alvardo Ct., Suite #200, San Diego, CA 92120 | 2010-10-15 |
| 1568783108 | Monica Gable | Physician Assistant | 2929 Health Center Dr., San Diego, CA 92123-7741 | 2010-06-17 |
| 1932422698 | Debbie Lo Flores | Physician Assistant | 5030 Camino De La Siesta Ste 204, San Diego, CA 92108-3118 | 2010-03-10 |
| 1801125034 | Lindsey R Hayes | Physician Assistant | Quentin Roosevelt Blvd, Building 8, San Diego, CA 92135-7051 | 2009-12-17 |
| Find all providers in SAN DIEGO | ||||
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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.