Provider Demographics
NPI:1619676053
Name:NAJERA, VICKIE C (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:C
Last Name:NAJERA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:C
Other - Last Name:GALLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5704 N COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1816
Mailing Address - Country:US
Mailing Address - Phone:559-824-7008
Mailing Address - Fax:
Practice Address - Street 1:5704 N COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1816
Practice Address - Country:US
Practice Address - Phone:559-824-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2022097178363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care