Provider Demographics
NPI:1912626318
Name:STONER, LILY DANIELLE (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:DANIELLE
Last Name:STONER
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 CORONA CT
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1617
Mailing Address - Country:US
Mailing Address - Phone:510-292-0736
Mailing Address - Fax:
Practice Address - Street 1:419 30TH ST # 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3374
Practice Address - Country:US
Practice Address - Phone:510-292-0736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236927367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife