Provider Demographics
NPI:1760417034
Name:BEGLEY, VICTORIA KATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KATHERINE
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 BROCKTON AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0102
Mailing Address - Country:US
Mailing Address - Phone:951-682-6900
Mailing Address - Fax:951-682-6905
Practice Address - Street 1:4646 BROCKTON AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0102
Practice Address - Country:US
Practice Address - Phone:951-682-6900
Practice Address - Fax:951-682-6905
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP15669363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner