Provider Demographics
NPI:1790989630
Name:REX-VITAL, LOQUINTHA DANIELLE (APRN-BC, BC-ADM, NP)
Entity Type:Individual
Prefix:MRS
First Name:LOQUINTHA
Middle Name:DANIELLE
Last Name:REX-VITAL
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Gender:F
Credentials:APRN-BC, BC-ADM, NP
Other - Prefix:
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Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:2921 SAVIERS RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-5314
Practice Address - Country:US
Practice Address - Phone:805-487-5588
Practice Address - Fax:805-487-5589
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2012-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA12617363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner