Healthcare Provider Details

I. General information

NPI: 1538987698
Provider Name (Legal Business Name): STEPHANIE CHRISTINE CALEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE CHRISTINE BAKER

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N ANAHEIM BLVD STE 101
ANAHEIM CA
92801-1202
US

IV. Provider business mailing address

26792 CARMENITA LN
MISSION VIEJO CA
92691-4309
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone: 949-682-6907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number95032296
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number800730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: