| Doctor Name: | MRS. PANADDA STACY |
| NPI Number: | 1013080068 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNP |
| License Number: | NP9619 |
| Business Practice Address: | 9985 Sierra Ave Fontana, CA - 923356720 |
| Business Phone Number: | 9094277031 |
| Business Fax Number: | 9094274127 |
| Mailing Address: | P.o.box 145, 5837 Mountain Home Creek Road ANGELUS OAKS |
| State: | CA |
| Postal Code: | 92305 |
| Phone Number: | 9097942081 |
| Fax Number: | 9094274127 |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | NP9619 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |