Healthcare Provider Details

I. General information

NPI: 1609780568
Provider Name (Legal Business Name): VALERIE REYNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2809
US

IV. Provider business mailing address

742 GALERITA ST
OXNARD CA
93030-7347
US

V. Phone/Fax

Practice location:
  • Phone: 805-948-5011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95041615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: