Provider Demographics
NPI:1679011589
Name:DE LOS REYES NATH, EILEEN (RN, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:DE LOS REYES NATH
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 OAK VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4615
Mailing Address - Country:US
Mailing Address - Phone:562-310-5665
Mailing Address - Fax:925-954-7575
Practice Address - Street 1:110 LA CASA VIA STE 205
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3017
Practice Address - Country:US
Practice Address - Phone:925-464-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-11
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily