Provider Demographics
NPI:1407356918
Name:REYNAGA-VARGAS, REYNA ACELA (FNP-C)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:ACELA
Last Name:REYNAGA-VARGAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2505
Mailing Address - Country:US
Mailing Address - Phone:951-689-2955
Mailing Address - Fax:
Practice Address - Street 1:8856 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-1365
Practice Address - Country:US
Practice Address - Phone:833-867-4642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008645363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily