Provider Demographics
NPI:1124144407
Name:STONE, CASEY MEISTER VANLARE (FNP-C)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MEISTER VANLARE
Last Name:STONE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:MEISTER
Other - Last Name:VAN LARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:26800 CROWN VALLEY PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8038
Mailing Address - Country:US
Mailing Address - Phone:949-364-1236
Mailing Address - Fax:949-364-5879
Practice Address - Street 1:26800 CROWN VALLEY PKWY STE 215
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8038
Practice Address - Country:US
Practice Address - Phone:714-364-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494541363LF0000X
CA11919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA494541OtherRN MEDICAL LICENSE
CA1912919804OtherGROUP NPI
CA11919OtherNP MEDICAL LICENSE
CA1912919804OtherMEDI-CAL - UNDER GROUP NPI
CA1912919804OtherGROUP NPI
CACB254087Medicare PIN