Provider Demographics
NPI:1699563189
Name:STAGG, STACIA ELISHA
Entity type:Individual
Prefix:
First Name:STACIA
Middle Name:ELISHA
Last Name:STAGG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67576 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6254
Mailing Address - Country:US
Mailing Address - Phone:760-663-6852
Mailing Address - Fax:
Practice Address - Street 1:67576 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6254
Practice Address - Country:US
Practice Address - Phone:760-663-6852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula