Provider Demographics
NPI:1831803543
Name:MCGREGOR, RICKIE (LVN)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23904 CALLE DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-3011
Mailing Address - Country:US
Mailing Address - Phone:707-373-1619
Mailing Address - Fax:
Practice Address - Street 1:23925 NEWHALL RANCH RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5701
Practice Address - Country:US
Practice Address - Phone:661-255-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA693262364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist