Healthcare Provider Details

I. General information

NPI: 1295651941
Provider Name (Legal Business Name): EMAN QAYSIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 MACARTHUR BLVD # 105
NEWPORT BEACH CA
92660-2512
US

IV. Provider business mailing address

4041 MACARTHUR BLVD STE 105
NEWPORT BEACH CA
92660-2512
US

V. Phone/Fax

Practice location:
  • Phone: 714-507-8064
  • Fax:
Mailing address:
  • Phone: 949-736-6102
  • Fax: 949-736-6102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95040293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: