Provider Demographics
NPI:1508531302
Name:MONTOYA, REYNA RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:RENEE
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31137 THREE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-4920
Mailing Address - Country:US
Mailing Address - Phone:951-526-1529
Mailing Address - Fax:
Practice Address - Street 1:31137 THREE OAKS DR
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-4920
Practice Address - Country:US
Practice Address - Phone:951-526-1529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily