Provider Demographics
NPI:1649036823
Name:Z. REYES, PRIMITIVA Z (MSN-FNP)
Entity type:Individual
Prefix:MRS
First Name:PRIMITIVA
Middle Name:Z
Last Name:Z. REYES
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5953 FIDLER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1252
Mailing Address - Country:US
Mailing Address - Phone:562-519-7175
Mailing Address - Fax:
Practice Address - Street 1:2571 W LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2619
Practice Address - Country:US
Practice Address - Phone:714-827-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028768363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner