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 1:7102 N FRESNO ST STE 108
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2905
Mailing Address - Country:US
Mailing Address - Phone:559-297-2259
Mailing Address - Fax:
Practice Address - Street 1:7102 N FRESNO ST STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2905
Practice Address - Country:US
Practice Address - Phone:559-297-2259
Practice Address - Fax:559-297-2269
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2022097178363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care