Healthcare Provider Details

I. General information

NPI: 1528670015
Provider Name (Legal Business Name): NORA REEM ALI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30492 GATEWAY PL., SUITE 110
RANCHO MISSION VIEJO CA
92694
US

IV. Provider business mailing address

30492 GATEWAY PL., SUITE 110
RANCHO MISSION VIEJO CA
92694
US

V. Phone/Fax

Practice location:
  • Phone: 949-542-7700
  • Fax: 949-361-8163
Mailing address:
  • Phone: 949-542-7700
  • Fax: 949-361-8163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025860
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95207751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: