Provider Demographics
NPI:1831824994
Name:OAKLEY, CARLY C (FNP)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:C
Last Name:OAKLEY
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 MESA VERDE DR E STE 226
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5258
Mailing Address - Country:US
Mailing Address - Phone:949-228-9308
Mailing Address - Fax:
Practice Address - Street 1:1525 MESA VERDE DR E STE 226
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5258
Practice Address - Country:US
Practice Address - Phone:949-228-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF07220251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily