Healthcare Provider Details

I. General information

NPI: 1154066355
Provider Name (Legal Business Name): VICTORIA LEAMER HUGHES MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA ANN LEAMER

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 110
COSTA MESA CA
92627-7762
US

IV. Provider business mailing address

1640 NEWPORT BLVD STE 110
COSTA MESA CA
92627-7762
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number100089-875
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95023171
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number510076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: