Healthcare Provider Details

I. General information

NPI: 1225602576
Provider Name (Legal Business Name): REBECCA K VALLEJO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40555 CALIFORNIA OAKS RD STE 112
MURRIETA CA
92562-5723
US

IV. Provider business mailing address

40555 CALIFORNIA OAKS RD STE 112
MURRIETA CA
92562-5723
US

V. Phone/Fax

Practice location:
  • Phone: 951-535-3070
  • Fax:
Mailing address:
  • Phone: 951-535-3070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: