Advanced Practice Providers

Kelly Bugos, NP

Urologic Oncology Nurse Practitioner

Kelly Bugos MS, ANP-BC is a Manager for the Center for Advanced Practice and a nurse practitioner specializing in cancer survivorship at Stanford Health Care. Ms. Bugos is the Director of the Advanced Practice Provider (APP) Fellowship Program. She founded the cancer survivorship clinics at Stanford in 2012 and continues to focus her clinical work on helping people touched by cancer restore their health after treatment. 

Joanne Chien, NP

Urologic Oncology Nurse Practitioner

Joanne is born and raised in Taiwan, bilingual in Mandarin and English, graduated with Masters of Science in Nursing with Gerontological Nurse Practitioner degree from University of California, San Francisco in 2008. She worked as a RN for 5 years on a Medical-Surgical unit at Stanford, and has worked as a Nurse Practitioner since 2010 with the first  4 years at the Community Living Center at VA Livermore and Menlo Park, and returned to Stanford working as a NP since 2014 in Urologic Medical Oncology specializing in treating urologic cancers, managing treatment related side effects and participating in clinical trials as a sub-investigator. Her top two StandOut strength roles are Equalizer and Creator.


Lori Guelman, NP

Urologic Oncology Nurse Practitioner
Lead APP

Lori completed her Master of Science in Nursing at Samuel Merritt University in 2007.  She worked in General Urology for over 12 years specializing in a spectrum of Urological problems including prostate cancer and she recently became the Lead APP for Urology Oncology and Radiation Oncology in March 2020, and will be working clinically with the Uro Onc surgical team.  Her research on urinary infections was published in the Society of Urologic Nursing in December 2019.  



Emanuella Leite, PA

Urologic Oncology Physician's Assistant




Kaidi Moore, PA

Urologic Oncology Physician's Assistant

Kaidi completed her PA degree at Stanford University and received Master’s degree from St. Francis University. She has previously studied nursing and worked as a RN with dialysis and oncology patients. After becoming a PA, she joined Stanford urology oncology team in November 2018.




Mika Ruiz, NP

Urologic Oncology Nurse Practitioner

Mika Ruiz is a board-certified family nurse practitioner. She received her Masters of Science in Nursing with distinction from San Francisco State University in 2018. Her NP training at world-renowned hospitals, most notably at UCSF Helen Diller Cancer Center in the Genitourinary Oncology division deepened her interest in her current role as an APP in the urologic oncology clinic at SHC.  In Dec 2019, she received her ONS Chemo and Immunotherapy Certificate.




Laura Ruffo, NP

Urologic Oncology Nurse Practitioner

Laura graduated with her Family Nurse Practitioner (FNP) degree from Columbia University School of Nursing. Her area of clinical practice is in urological surgical oncology, specializing in kidney, bladder, prostate, testicular, and penile cancer.




Lillian Shiiba, PA-C

Urologic Oncology Surgical Physician's Assistant

Lillian completed her Master of Science and Physician Assistant studies at the University of Medicine and Dentistry of New Jersey.  Upon graduation, she worked at UCSF in Head and Neck Surgery for 5 years.  She was recruited to the new Stanford Cancer Center in 2004 and continued to work in Head and Neck Surgery.  She transitioned to Urologic Oncology in 2007, specializing in prostate biopsies and care for all Urologic Oncology patients. 




Peter Dy, NP

Urology Nurse Practitioner 

Peter is an Inpatient Urology Nurse Practitioner joining the Urology team in 2019. He graduated from The Ohio State University in 2017 with a Master’s of Science in Nursing in Adult-Gerontology Acute Care. He has also worked as a perioperative RN for 4 years at The James Comprehensive Cancer Center in Columbus, OH getting surgical oncology patients ready for surgery and recovering them afterward. Prior to his career as a nurse, Peter was a researcher studying cartilage development at the Cleveland Clinic that resulted in several publications.


Rebecca Hunt, NP

Urology Nurse Practitioner 

Rebecca completed her Masters of Science in Nursing in 2017 at The Ohio State University.  She specialized in Oncology after completing the Advanced Practice Provider (APP) Oncology Fellowship at Stanford in 2018. She joined the Urology team in 2018, working in the hospital focusing on managing post-operative care.


Christine Rico Erb, NP

Urology and Urologic Oncology Nurse Practitioner (Valleycare)

Christine received her Master's in Nursing at Samuel Merritt University. She began her career as a Nurse Practitioner at Stanford Healthcare in 2007. She has worked in Radiation Oncology and Anesthesia Preoperative Evaluation Clinic. She joined the Urology team in Pleasanton (ValleyCare) in 2019 where sees patients in general urology and urology oncology in both outpatient and inpatient settings. Christine is also fluent in Tagalog. In her free time she loves to travel, spend time with her 2 daughters and being outdoors.



Catherine Arima, NP

Urology Nurse Practitioner (Emeryville)

Cate Arima graduated from the Family Nurse Practitioner program at UCSF in 2007. She joined Stanford Urology in 2015. She greatly enjoys connecting with her patients in a meaningful way and values an integrative approach in caring for her patients. She is currently a fellow in the Andrew Weil Integrative Medicine Fellowship program and a recipient of the Andrew Weil Integrative Medicine Scholarship. With her education she hopes to continue to support her patients by empowering them to incorporate integrative practices with their traditional western approaches to medicine and care.


Pamela Piacente, PA-C

Urology Robotic Surgery Physician's Assistant

Pamela Piacente, PA-C, is a graduate of the D'Youville College Physician Assistant Program in Upstate New York. She also obtained a Masters Degree in Microbiology from the State University of New York at Buffalo. Initially trained in Urologic Oncology, and a pioneer in Robotic Surgery at Roswell Park Comprehensive Cancer Center in Buffalo, New York. She has been clinically practicing as a Robotic Surgery Physician Assistant in the Department of Urology at Stanford Health Care since 2011. She has over 15 years of experience working with da Vinci Surgical System platforms and is an integral part of the Stanford Medicine resident training program.



Mechele Magpusao Wu, NP

Urology Surgery Nurse Practitioner

Mechele graduated with her Master of Science degree in Nursing from the University of California, San Francisco, in 2001. She has enjoyed working as a Nurse Practitioner since then, with experience in urogynecology and in general surgery before joining the Urology Clinic at Stanford in 2004.

Her clinical expertise includes general urology, female urology, urinary incontinence, pelvic prolapse, voiding dysfunction, urinary tract infections, urinary stone disease, neurourology, and interstitial cystitis/painful bladder syndrome.




Cathy Costaglio, Pediatric NP

Pediatric Urology Nurse Practitioner





Justine Dela Cruz, Pediatric NP

Pediatric Urology Nurse Practitioner

Justine is a Board Certified Family Nurse Practitioner. She obtained her Bachelor's of Science in Public Health from UC Irvine, Bachelor's of Science in Nursing from NYU, and Master's of Science in Nursing from Columbia University. She worked as an RN on a medical surgical GI unit at Mount Sinai while in NYC, and upon moving back home to the Bay Area, she worked as an NP in the Digestive Health clinic at Stanford, specializing in Inflammatory Bowel Disease. Her dream was always to work with kids, so she was ecstatic to join the pediatric urology team here at Lucile Packard Children's Hospital, where she will be covering the inpatient service. In her free time, she enjoys traveling, running, being outdoors, and spending time with family and friends!





Sarah Oppenheim, Pediatric NP

Pediatric Urology Nurse Practitioner

Sarah is a Bay Area native who completed undergraduate studies at UC Berkeley (go bears!) and graduate pediatric nursing training at UCSF.  She is a board certified pediatric nurse practitioner who has been working on Stanford Children’s Health’s pediatric urology team since 2014.  She covers ambulatory, inpatient, and operative services at our satellite clinic sites in San Francisco at CPMC and in Walnut Creek at John Muir Medical Center.  Outside of work her two small children keep her busy, laughing, and on her toes.





Susan Pike, Pediatric NP

Pediatric Urology Nurse Practitioner

Susan is a board certified pediatric nurse practitioner who worked in general pediatrics for many years prior to joining Stanford Pediatric Urology in 2006.  She is bilingual in Spanish and English.  Susan works in our Sunnyvale clinic.  When she is not working, Susan enjoys sailing, hiking and stand up paddling.






Mala Sivapalasingam, Pediatric NP

Pediatric Urology Nurse Practitioner






Denise Stines, Pediatric NP

Pediatric Urology Nurse Practitioner






Why Choose An APP as your Healthcare Provider?

APPs are licensed providers and include both nurse practitioners (NPs) and physician assistants (PAs).  They provide high-quality healthcare services similar to those of a doctor. APPs  have a unique approach and stress both care and cure. Besides clinical care, APPs focus on health promotion, disease prevention, health education and counseling. They help patients make wise health and lifestyle choices. They are truly your Partners in Health. Our urology APPs are all highly experienced in urology and work side-by-side with our physicians in our outpatient and inpatient settings.

How long have APPs been providing health care?

NPs have provided excellent health care for more than 42 years. The first NPs were educated at the University of Colorado in 1965. The first PA class graduated from the Duke University PA program on Oct. 6, 1967.

How are APPs educated?

NPs are nurses (RNs) who have complete additional training in a master's or doctoral degree program including  advanced clinical training.  PAs come from a variety of backgrounds and have varying degrees from bachelors to master’s or PhD degrees.  The Stanford University Master of Science PA program opened in 2016 and has been highly successful. 

What services do APPs provide?

From treating illness to advising patients on maintaining a healthy lifestyle, APPs provide a full range of services. They work closely with our physicians in all three of our divisions to provide comprehensive initial and follow up care for our urology patients.  Patients who see our APPs report an extremely high level of satisfaction with the care they receive.  Among the many services that APPs provide, they:

  • Diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries.  Manage many non-operative urologic problems such as voiding dysfunction, urinary tract infections, bladder or prostate pain, erectile dysfunction, and elevated PSA, and pediatric problems such as bedwetting and incontinence. 
  • Manage early and long-term follow up of patients who have undergone surgical procedures
  • Order, perform and interpret diagnostic tests such as lab work and x-rays
  • Prescribe medications and other treatments
  • Manage patients' overall care and spending time counseling patients
  • Perform some office procedures such as wound care, cystoscopy and ureteral stent removal, catheter placement or exchange, and prostate biopsies.  For our pediatric patients they perform some procedures such as urodynamic testing and biofeedback.