Provider Demographics
NPI:1821235425
Name:STACEY, HELEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:L
Last Name:STACEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:STACEY
Other - Last Name:BERNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2255 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3343
Mailing Address - Country:US
Mailing Address - Phone:925-937-9984
Mailing Address - Fax:925-933-4886
Practice Address - Street 1:2255 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3343
Practice Address - Country:US
Practice Address - Phone:925-937-9984
Practice Address - Fax:925-933-4886
Is Sole Proprietor?:No
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine