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General NPI Number Information
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NPI Number | 1891977104
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Entity Type | Individual
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Provider Name | VERONICA I VEGA MSN, FNP , PHN
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Gender | Female
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 751 LOMBARDI CT STE B
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City | SANTA ROSA
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State | CA
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Zip | 95407-5454
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Country | US
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Telephone | 707-479-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 900 SOUTHAMPTON RD APT 159
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City | BENICIA
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State | CA
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Zip | 94510-1816
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Country | US
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Telephone | 707-315-4094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021407
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License Number State | CA
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