Provider Demographics
NPI:1073278180
Name:OREJEL, EDITH GUADALUPE (MSN, RN, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:GUADALUPE
Last Name:OREJEL
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:GUADALUPE
Other - Last Name:OREJEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1455 FRAZEE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4350
Mailing Address - Country:US
Mailing Address - Phone:619-843-1166
Mailing Address - Fax:
Practice Address - Street 1:1455 FRAZEE RD STE 500
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4350
Practice Address - Country:US
Practice Address - Phone:619-843-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95091522363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health