Provider Demographics
NPI:1235600826
Name:SUNDLING, STACEY LEIGH (RN, PHN)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:LEIGH
Last Name:SUNDLING
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:LEIGH
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:3609 OCEAN RANCH BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056
Mailing Address - Country:US
Mailing Address - Phone:760-967-4401
Mailing Address - Fax:760-967-4644
Practice Address - Street 1:6598 DAYLILY DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1266
Practice Address - Country:US
Practice Address - Phone:858-705-2804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-08
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022242163WH0200X, 163WX0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX0200XNursing Service ProvidersRegistered NurseOncology